EXTREME LATERAL INTERBODY FUSION IN PACIENTS WITH CHRONIC LOW BACK PAIN

To evaluate the effect of lateral lumbar interbody fusion (LLIF) or oblique interbody fusion (OLIF) on low back pain due to degenerative intervertebral disc disease.

Methods:

We systematically reviewed articles on surgical treatment of low back pain by LLIF and OLIF, according to the Cochrane Handbook for Systematic Reviews of Interventions. We searched through electronic databases, including Medline via PubMed, Lilacs through the Virtual Health Library (VHL), Cochrane Collaboration/Central and Cohrane/Dare Cochrane Controlled Trials Register, without language or publication date restrictions and with design for prospective cohorts and randomized clinical trials.

Results:

We have selected and presented three studies.

Conclusion:

The literature review showed great relevance in the improvement of the new surgical approach (LLIF) in relation to TLIF, but greater content availability in the databases is necessary to reach a satisfactory conclusion regarding the efficiency of the lateral approach and its advantages over other traditional procedures. Level of Evidence II, Systematic review of Level II studies.

Keywords:
Low Back Pain; Intervertebral Disc; Arthrodesis

Number	Author	Year	Country	Study design	Patients in the intervention group (N)	Patients in the control group (N)	Clinical outcomes evaluated
1	Phillips et al.¹²12. Phillips FM, Isaacs RE, Rodgers WB, Khajavi K, Tohmeh AG, Deviren V, et al. Adult degenerative scoliosis treated with XLIF: clinical and radiographical results of a prospective multicenter study with 24-month follow-up. Spine. 2013;38(21):1853-61.	2013	USA	Prospective cohort	-LLIF (20)	(0)	-VAS, ODI
					-LLIF + anterolateral fixation (7)		-Surgical time
					-LLIF + posterior fixation (80)		-Blood loss
							-Loss of strength
							-Neuropathy
							-Reoperation
2	Marchi et al.¹³13. Marchi L, Abdala N, Oliveira L, Amaral R, Coutinho E, Pimenta L. Stand-alone lateral interbody fusion for the treatment of low-grade degenerative spondylolisthesis. Sci World J. 2012;2012:456346.	2012	Brazil	Prospective cohort	-LLIF (52)	(0)	-VAS, ODI
							-Surgical time
							-Blood loss
							-Olisthesis
							-Increased disc height
							-Total lordosis
							-Segmental lordosis
							-Bone healing
3	Sembrano et al.¹⁴14. Sembrano JN, Tohmeh A, Isaacs R, SOLAS Degenerative Study Group. Two-year comparative outcomes of MIS lateral and MIS transforaminal interbody fusion in the treatment of degenerative spondylolisthesis: Part I: clinical findings. Spine. 2016;41(Suppl 8):S123-32.	2016	USA	Randomized Clinical Trial	LLIF (29)	TLIF (26)	-VAS, ODI
							-Surgical time
							-Blood loss
							-Loss of strength
							-Post-operative fracture
							-Neuropathy

Study	N	Initial mean	Final mean	Mean difference	SD
1	82	7.20	3.8	3.40	3.1
2	52	7.80	3.1	4.70	2.18
3	42	7.3	1.9	5.40	-

Study	N	Initial mean	Final mean	Mean difference	SD
1	82	48.50	27.00	21.50	20.00
2	52	66.00	30.00	36.00	16.80
3	42	43.00	20.00	23.00	-

Study	N	Mean	SD
1	82	177.90	60.59
2	52	73.20	31.40
3	42	171.00	-

ATHA EDITORA Rua: Machado Bittencourt, 190, 4º andar - Vila Mariana - São Paulo Capital - CEP 04044-000, Telefone: 55-11-5087-9502 - São Paulo - SP - Brazil
E-mail: actaortopedicabrasileira@uol.com.br

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[1] Correspondence: Alberto Augusto Ferreira Neto. Rua Dr. Almeida Lima, 1134, Parque da Mooca, São Paulo, SP, Brazil, 03164000. alberto_f.neto@globo.com