Clinical Perspective-The Case for Adoption of LLIF

Open surgical procedures have been the mainstay of spinal surgery for decades, but minimally invasive spinal surgery (MIS) has recently gained traction. Translaterally placed cages permit insertion of large cages and promote skeletal realignment and fusion. Lateral surgical procedures with percutaneous skeletal fixation and good fusion allow patients to leave the hospital earlier with fewer complications as compared with open procedures. The challenging learning curve is often a barrier to adoption for surgeons, many of whom believe that their open methods work well. MIS and open surgical procedures are reported to have similar outcomes at 1 year; in the first 6 weeks, patients undergoing open surgery often need blood transfusion, develop infection, and use more narcotics. Spine surgery has been associated with modulus mismatch between osteoporotic bone and titanium and the need for multiple painful and traumatic surgical procedures, and spine surgeons continue the quest to find better ways to do things.