The Resident’s Guide to Spine Surgery by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9783030208479
Publisher: Springer International Publishing

20. Lateral Lumbar Interbody Fusion L1–2, L2–3

Ryan DenHaese1, Clint Hill2 and Jeffrey H. Weinreb3

(1)Axis Neurosurgery and Spine, Williamsville, NY, USA

(2)The Orthopedic Institute, Paducah, KY, USA

(3)Department of Orthopedic Surgery, The George Washington University Hospital, Washington, DC, USA

Keywords

Lateral lumbar interbody fusionLumbar spineInfradiaphragmatic retroperitonealRetropleuralDegenerative disc diseaseAdjacent segment disease

Background and Indications

The most common indication for lateral lumbar interbody fusion (LLIF) at the L1–L2 and L2–L3 levels is adjacent segment failure. Other reasons for fusion via the lateral approach at these levels include anterior longitudinal ligament (ALL) release, deformity surgery, scoliosis correction, and corpectomy due to tumor, trauma, infection, or deformity [1]. The lateral approach may be useful for fusion of the lumbar spine above L-5 if the anatomy is conducive to the approach. The L2–L3 level is considered one of the most easily and safely accessed levels utilizing the lateral trans-psoas approach. The L1–L2 level, however, can be one of the most challenging lumbar levels due to the proximity to the diaphragmatic crus and thoracic cavity and due to the lower ribs interfering with a direct, in-line exposure [2].

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