radiographic and surgical outcomes after stand-alone lateral lumbar interbody fusion

Objectives: laterallumbarinterbody fusion (llif) is increasingly being utilized in isolation to achieve a large surface-area interbody fusion with an indirect decompression for spinal stenosis. this retrospective chart review was done to determine the viability of performing stand-alone (sa) llif. methods: forty-nine patients at least 18 years of age with minimum one-year follow-up at a single institution underwent sa-llif using minimally invasive surgery (mis) approach without further posterior surgery between 2011 and 2015. one to five-level fusions were included. retrospective review of surgical outcomesandradiographic parameters were examined preoperatively, acutely postoperatively and at 1 year postoperatively. results: forty-nine patients (102 spinal segments) underwent sa-llif. fusion levels ranged from one to five with a mean of 2.1 ±2.1. mean blood loss was 68 ± 63.2cc and mean surgical time was 143.4 ± 66.5 minutes. fifty-seven percent had undergone prior spine surgery unrelated to their index procedure. complication rate was 38.9% and reoperation rate was 20.4%. no difference in complication rates was noted between constructs with three or more levels fused versus less than three levels fused. at one-year, significant improvement was noted with pelvic tilt, pelvic incidence, and lumbar lordosis. conclusions: sa-llif is an optional mis treatment of stable degenerative disc disease and spinal stenosis, with good one-year correction and maintenance of radiographic parameters. with complication rate of 38.9% and reoperation rate of 20.4%, true benefit of forgoing posterior supplemental fixation may be questioned.