Journal of Spine

Laterally Placed Expandable Interbody Spacers with Adjustable Lordosis Improve Radiographic and Clinical Outcomes

Abstract

Yan Michael Li, Zheng Huang, James Towner, Yan Icy Li, Jessica R. Riggleman and Charles Ledonio

Introduction: Minimally invasive lateral lumbar interbody fusion (MIS LLIF) been shown to minimize soft tissue dissection and blood loss in comparison to open posterior lumbar interbody fusion. This study describes the clinical and radiographic outcomes of patients treated with expandable interbody spacers with adjustable lordosis for MIS LLIF.
Methods: Single surgeon retrospective Institutional Review Board-exempt chart review on 57 consecutive patients who underwent MIS LLIF at 1–2 contiguous level(s) using expandable spacers with adjustable lordosis, which allow for expansion in height and lordosis. Radiographic and clinical functional outcomes were collected and compared at preoperative and postoperative time points up to 12 months. Statistical results were significant if P<0.05.
Results: Fifty-seven consecutive patients were evaluated with an average age of 58 ± 12.3 years, and 49.1% were female. Visual Analog Scale (VAS) for back pain and Oswestry Disability Index (ODI) scores decreased significantly at 12 months. Lumbar lordosis improved by a mean of 5.1° at 12 months (P<0.001). Anterior, middle, and posterior disc height significantly increased at 12 months by means of 5.2 mm, 4.6 mm, and 2.6 mm respectively (P<0.001). Neuroforaminal height increased by a mean of 3.7 mm (P<0.001) while segmental lordosis improved by 3.7° at 12 months.
Discussion and Conclusion: This study showed significant positive clinical and radiographic outcomes for patients who underwent MIS LLIF using expandable interbody spacers with adjustable lordosis based on decreased VAS back pain and ODI scores at 1-year follow-up. The use of expandable spacers with adjustable lordosis was shown to be safe and effective for the cohort studied.