IngentaConnect L5-S1 Laparoscopic Anterior Interbody Fusion

Authors: Frantzides, Constantine T.¹; Zeni, Tallal M.¹; Phillips, Frank M.²; Mathur, Sameer²; Zografakis, John G.³; Moore, Ronald M.⁴; Laguna, Luis E.¹

Source: JSLS, Journal of the Society of Laparoendoscopic Surgeons, Volume 10, Number 4, October - December 2006 , pp. 488-492(5)

Publisher: Society of Laparoendoscopic Surgeons

Abstract:

Objective: We evaluated our experience with laparoscopic L5-S1 anterior lumbar interbody fusion (ALIF).

Methods: This represents a retrospective analysis of consecutive patients who underwent L5-S1 laparoscopic ALIF between February 1998 and August 2003.

Results: Twenty-eight patients underwent L5-S1 LAIF (15 males and 13 females). The mean age was 43 years (range, 26 to 67). Mean operative time was 225 minutes (range, 137 to 309 minutes). No conversions to an open procedure were necessary. Twenty-four (85.7%) patients underwent successful bilateral cage placement. Four patients (14.3%) in whom only a single cage could be placed underwent supplementary posterior pedicle screw placement. Mean length of stay (LOS) was 4.1 days (range, 2 to 15). Two patients underwent reoperation subacutely secondary to symptomatic lateral displacement of the cage. One patient developed radiculopathy 6 months postoperatively and required reoperation. One patient developed a small bowel obstruction secondary to adhesions to the cage requiring laparoscopic reoperation. Fusion was achieved in all patients. Visual analogue scale scores for back pain were significantly improved from 8.6±0.8 to 2.8±0.8 (P<0.0001) at 1 year.

Conclusion: L5-S1 LAIF is feasible and safe with all the advantages of minimally invasive surgery. Fusion rates and pain improvement were comparable to those with an open repair.

Keywords: MINIMALLY INVASIVE SURGERY; ANTERIOR LUMBAR INTERBODY FUSION; CAGES; RHBMP-2

Document Type: Research article

Affiliations: 1: Minimally Invasive Surgery Center, Department of Surgery, Evanston Northwestern Healthcare and Northwestern University, Evanston, Illinois, USA 2: Department of Orthopedic Surgery, Rush University, Chicago, Illinois, USA 3: Advanced Laparoscopy - Surgery for Northeast Ohio Centers of Excellence, Akron, Ohio, USA 4: Department of Surgery, Plantation Hospital, Fort Lauderdale, Florida, USA