@article{JSS4747,
author = {Gregory M. Malham and Timothy P. Wagner and Matthew H. Claydon},
title = {Anterior lumbar interbody fusion in a lateral decubitus position: technique and outcomes in obese patients},
journal = {Journal of Spine Surgery},
volume = {5},
number = {4},
year = {2019},
keywords = {},
abstract = {Background: Multilevel lumbar interbody fusion (LIF) surgery in obese patients is problematic, with positioning and anaesthetic risks during posterior approaches, vascular and visceral complications during anterior approaches, and lack of access to L5/S1 during lateral approaches. Modified anterior LIF (ALIF) via an anterolateral retroperitoneal approach in the lateral decubitus position permits access to L3/4, L4/5, and L5/S1 levels without patient repositioning. This study reports our initial experience with this lateral ALIF in obese patients and describes modifications of existing lateral and anterior techniques.
Methods: We retrospectively analysed a prospectively maintained registry including the first 30 consecutive patients who underwent lateral ALIF. In all patients, supine ALIF was relatively contraindicated because of obesity or previous abdominal surgery. All patients had a body mass index (BMI) ≥30 kg/m2. Fusion was assessed by high-definition computed tomography. Patient-reported outcomes included visual analogue scale pain scores, Oswestry Disability Index (ODI), and 36-Item Short-Form Survey (SF-36) physical and mental component scores (PCS and MCS). All patients underwent ≥2 years follow-up.
Results: At last follow-up (mean, 35.0 months) mean back pain improved 64%, leg pain improved 67%, ODI improved 54%, and PCS and MCS both improved 37% (P},
issn = {2414-4630}, url = {https://jss.amegroups.org/article/view/4747}
}