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Title: Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF.
Authors: Malham, Gregory
Other Authors: Mobbs, Ralph
Phan, Kevin
Seex, Kevin
Rao, Prashanth
Keywords: Degenerative Disc Disease
Anterior Lumbar Interbody Fusion
Anterior to Psoas
Lateral Lumbar Interbody Fusion
Lumbar Spine Fusion
Minimally Invasive
Oblique Lumbar Interbody Fusion
Posterior Lumbar Interbody Fusion
Transforaminal Lumbar Interbody Fusion
Facet Joint Disease
Lumbar Interbody Fusion
Neurosciences Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Dec-2015
Publisher: OSS Press Ltd
Citation: J Spine Surg. 2015 Dec;1(1):2-18.
Abstract: Degenerative disc and facet joint disease of the lumbar spine is common in the ageing population, and is one of the most frequent causes of disability. Lumbar spondylosis may result in mechanical back pain, radicular and claudicant symptoms, reduced mobility and poor quality of life. Surgical interbody fusion of degenerative levels is an effective treatment option to stabilize the painful motion segment, and may provide indirect decompression of the neural elements, restore lordosis and correct deformity. The surgical options for interbody fusion of the lumbar spine include: posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), minimally invasive transforaminal lumbar interbody fusion (MI-TLIF), oblique lumbar interbody fusion/anterior to psoas (OLIF/ATP), lateral lumbar interbody fusion (LLIF) and anterior lumbar interbody fusion (ALIF). The indications may include: discogenic/facetogenic low back pain, neurogenic claudication, radiculopathy due to foraminal stenosis, lumbar degenerative spinal deformity including symptomatic spondylolisthesis and degenerative scoliosis. In general, traditional posterior approaches are frequently used with acceptable fusion rates and low complication rates, however they are limited by thecal sac and nerve root retraction, along with iatrogenic injury to the paraspinal musculature and disruption of the posterior tension band. Minimally invasive (MIS) posterior approaches have evolved in an attempt to reduce approach related complications. Anterior approaches avoid the spinal canal, cauda equina and nerve roots, however have issues with approach related abdominal and vascular complications. In addition, lateral and OLIF techniques have potential risks to the lumbar plexus and psoas muscle. The present study aims firstly to comprehensively review the available literature and evidence for different lumbar interbody fusion (LIF) techniques. Secondly, we propose a set of recommendations and guidelines for the indications for interbody fusion options. Thirdly, this article provides a description of each approach, and illustrates the potential benefits and disadvantages of each technique with reference to indication and spine level performed.
DOI: 10.3978/j.issn.2414-469X.2015.10.05
PubMed URL:
ISSN: 2414-469X
Journal Title: Journal of Spine Surgery
Type: Journal Article
Affiliated Organisations: NeuroSpine Surgery Research Group (NSURG), Sydney, Australia.
Prince of Wales Private Hospital, Randwick, Sydney, Australia.
University of New South Wales (UNSW), Sydney, Australia.
Neurosurgery Department, Macquarie University, Sydney, Australia.
Type of Clinical Study or Trial: Narrative Reviews
Appears in Collections:Neurosciences

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