Introduction: To the best of our knowledge, no study reporting the outcomes of combined lateral lumbar interbody fusion with posterior fixation using cortical bone trajectory (CBT) screws has been reported. This technique can be used to treat a range of conditions including but not limited to lumbar spondylosis, lumbar spondylolisthesis, lumbar herniated disc, lumbar spinal stenosis, and lumbar radiculopathy. The purpose of this study was to determine the clinical and radiological outcomes of this treatment combination.
Methods: The study included 60 consecutive patients over a 3 year period who received lateral lumbar interbody fusion as well as posterior fixation using CBT screws. Patients with one or two level fusion were included in the study. Operative duration and blood loss as well as complications related to surgery and were noted. Clinical symptoms were evaluated in office prior to surgery and after surgery at follow-up. Pain was measured using a traditional scale of 1 to 10 scoring. Fusion was assessed radiologically with x-ray and CT scan.
Results: Patient ages ranged from 34-79 years old with 31 males and 29 females in the study. Nine patients had two-level fusions while the remaining fifty-one had just one level. The mean operative time and intraoperative blood loss was 226 minutes and 135 mL respectively. Postoperative pain was improved in 88.3% of patients. Bony union occurred in 95% of cases. There was one case of incisional infection, and symptomatic adjacent segment disease developed in 4 patients.
Conclusions: Combined lateral lumbar interbody fusion with posterior fixation using CBT screws is safe and highly effective in treating a variety of conditions affecting the lumbar spine. This technique significantly improved patient pain scores and resulted in high rates of bony union.
Patient Care: With this research, we present an evaluation of minimally invasive techniques that can be used in lumbar interbody fusion for treatment of a variety of conditions. These techniques are highly effective for improving patient pain scores and achieving fusion while reducing morbidity. We hope that those reading will consider using these techniques for lumbar interbody fusion.
Learning Objectives: Evaluate the operative efficacy and safety of lateral lumbar interbody fusion with posterior fixation.
Assess the long term outcomes for patients receiving this treatment.
Describe some of the conditions that can be treated using this approach.