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Armocida D, Perna A, Cofano F, Cimatti M, Arcidiacono UA, Marengo N, Ajello M, Garbossa D, Proietti L, Tamburrelli FC, Maiotti M, Santoro A, Frati A. Extreme Lateral Interbody Fusion (XLIF) with Lateral Modular Plate Fixation: Preliminary Report on Clinical and Radiological Outcomes. Acta Neurochir Suppl 2023; 135:431-437. [PMID: 38153505 DOI: 10.1007/978-3-031-36084-8_66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
The lateral transpsoas approach (extreme lateral interbody fusion, or XLIF) allows surgeons to use various lordotic cage sizes to help restore intervertebral disk height, correct sagittal alignment, and improve fusion rates. The use of standalone devices has consistently raised doubts due to the high risk of complications and inadequate functional recovery that a circumferential arthrodesis can support. The recent introduction of a novel XLIF cage with adapted lateral plate fixation (XLPF) may further enhance the structural rigidity, consolidating the cage and plate into a singular modular entity. Nine patients from our surgical centers underwent a procedure of 1-level XLIF with XLPF in selected cases. We observed that XLPF does not extend the intraoperative footprint and provides immediate rigidity to the anterior column without any additional risk of complications and with minimal increased time compared to the traditional cage implant procedure. Although it has been shown that the use of interbody fusion cages with supplemental posterior fixation improves stabilization in all directions, the technique of standalone lateral cages may also have a place in spine surgery in that the stability may be sufficient in selected cases, such as junctional syndrome and in some forms of degenerative scoliosis.
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Affiliation(s)
- Daniele Armocida
- Neurosurgery Division, Human Neurosciences Department, "Sapienza" University, Rome (RM), Italy
| | - Andrea Perna
- Division of Spinal Surgery, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Fabio Cofano
- Spine Surgery Unit-Humanitas Gradenigo, Torino, Italy
- Department of Neuroscience, "Rita Levi Montalcini," University of Torino, Torino, Italy
| | - Marco Cimatti
- Unit of Neurosurgery, Sant'Andrea Hospital, Rome, Italy
| | | | - Nicola Marengo
- Unit of Neurosurgery, AOU Città della Salute e della Scienza, Torino, Italy
| | - Marco Ajello
- Unit of Neurosurgery, AOU Città della Salute e della Scienza, Torino, Italy
| | - Diego Garbossa
- Department of Neuroscience, "Rita Levi Montalcini," University of Torino, Torino, Italy
- Unit of Neurosurgery, AOU Città della Salute e della Scienza, Torino, Italy
| | - Luca Proietti
- Division of Spinal Surgery, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
- Institute of Orthopaedic, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Ciro Tamburrelli
- Division of Spinal Surgery, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
- Institute of Orthopaedic, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Maiotti
- Shoulder Unit Villa Stuart Clinic (Rome), Shoulder-Knee Unit PIO XI Clinic (Rome), Rome, Italy
| | - Antonio Santoro
- Neurosurgery Division, Human Neurosciences Department, "Sapienza" University, Rome (RM), Italy
| | - Alessandro Frati
- Neurosurgery Division, Human Neurosciences Department, "Sapienza" University, Rome (RM), Italy
- IRCCS "Neuromed", Pozzilli (IS), Italy
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