Mini-open approach for direct lateral lumbar interbody fusion

Area of Science:

• Spine surgery
• Minimally invasive techniques
• Orthopedic surgery

Background:

• Minimally invasive lateral approaches for lumbar spine surgery are gaining popularity.
• These techniques, including XLIF and DLIF, are modifications of the mini-open method.
• They utilize specialized tubular dilators and retractor systems.

Purpose of the Study:

• To introduce the mini-open lateral approach for anterior lumbar interbody fusion (ALIF).
• To investigate the advantages, technical pitfalls, and complications associated with this approach.
• To provide foundational knowledge for extreme lateral interbody fusion (XLIF) and direct lumbar interbody fusion (DLIF).

Main Methods:

• Retrospective analysis of 74 patients who underwent mini-open lateral approach surgery.
• Data collected included blood loss, operation time, incision size, mobilization time, hospital stay, and complications.
• Analysis covered procedures from September 2000 to April 2008 for various disease entities.

Main Results:

• Reported blood losses ranged from 61.2 mL (one level) to 400 mL (four levels).
• Operation times varied from 86 minutes (one level) to 190 minutes (four levels).
• Complications included retroperitoneal hematoma (2 cases), pneumonia (1 case), and transient lumbosacral plexus palsy (3 cases).

Conclusions:

• The mini-open lateral approach serves as a beneficial precursor to XLIF or DLIF.
• Special attention and management are necessary for potential complications, particularly transient lumbosacral plexus palsy.