Characterizing and Improving Nomenclature for Reporting Lumbar Interbody Fusion Techniques

Area of Science:

• Spine Surgery
• Orthopedic Surgery
• Neurosurgery

Background:

• Lumbar interbody fusion (LIF) techniques have evolved, leading to a proliferation of terminology.
• Current LIF nomenclature is characterized by inconsistency, redundancy, and ambiguity.
• A systematic analysis of LIF terminology in contemporary literature is needed.

Approach:

• A systematic review of LIF terminology was conducted using PubMed.
• 1455 articles were identified, with 605 references to LIF.
• A LIF reporting guideline was developed to standardize terminology.

Key Points:

• The most common anatomical approaches were transforaminal (43.0%), posterior (25.0%), lateral (19.7%), and anterior (10.9%).
• 72 unique terms described LIF, with significant overlap and ambiguity in prefixes/suffixes (e.g., MI, MIS, MISS for minimally invasive; O, CO, TO for open).
• Endoscopic-assisted procedures were variably described (Endo, Endoscopic-assisted, PE).

Conclusions:

• The existing LIF nomenclature is problematic due to inconsistent definitions and ambiguity.
• A standardized 4-part naming system for LIF is proposed.
• This system emphasizes intraoperative repositioning, patient position, anatomical approach, and surgical corridor orientation to psoas muscles.