Related Experiment Video
Updated: May 31, 2026
Lateral-PLIF for Lumbar Spinal Arthrodesis: A Detailed Step-By-Step Surgical Technique
Published on: January 23, 2026
Comparative Study of Posterior Lumbar Interbody Fusion Using Expandable Cages versus Lateral Lumbar Interbody Fusion
Atsushi Tanaka1, Hiroaki Kimura1, Takashi Sono2
1Department of Orthopedic Surgery, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan.
Objective:
Lumbar canal stenosis associated with osteoporotic vertebral fractures is rare, and optimal surgical strategies remain controversial. While anterior reconstruction is considered beneficial, no studies have compared lateral lumbar interbody fusion (LLIF) and extensive posterior lumbar interbody fusion (Ex-PLIF). This study compared the efficacy and safety of Ex-PLIF and LLIF for lumbar canal stenosis associated with osteoporotic vertebral fractures.
Methods:
We retrospectively reviewed 40 patients from 5 hospitals treated between 2015 and 2022. Patients underwent 1-level or 2-level Ex-PLIF (n = 22) or LLIF (n = 18). Assessment included demographics, activities of daily living, operative parameters, complications, and radiographic outcomes. A novel fracture classification based on coronal computed tomography endplate morphology (asymmetry, flat, concave) was developed.
Results:
Both groups showed significant postoperative activities of daily living improvement. Intraoperative blood loss was significantly lower in the LLIF group (P = 0.004). The LLIF group also demonstrated significantly less correction loss of the local lordotic angle compared to the Ex-PLIF group (P < 0.05). No significant differences in postoperative complications were observed. Regarding fracture classification, asymmetry was more frequent in the Ex-PLIF group (n = 5 vs. n = 1). Fixation involving L5/S1 occurred only in the Ex-PLIF group (n = 4).
Conclusions:
LLIF is superior to Ex-PLIF regarding blood loss and maintenance of sagittal correction. However, Ex-PLIF remains a viable option for patients requiring L5/S1 involvement or those presenting with asymmetric vertebral endplate morphology.
