Vassilis Lykomitros
Greek National Liaison for Eurospine, Greece
Title: Laparoscopic anterior lumbar interbody fusion with large lordotic cage
Biography
Biography: Vassilis Lykomitros
Abstract
We present our experience with the laparoscopic anterior lumbar fusion and demonstrate the technique with a single, large, lordotic cage, as a new and innovative method for 360 or 540 degree interbody fusions for demanding L5-S1 fusion cases. Materials-Methods: Twelve patients underwent laparoscopic ALIF between October 2010 and April 2014. Mean patient age was 49 years. Patient inclusion criteria were spondylolisthesis, trauma and failure of previous posterior fusion. In the spondylolisthesis and the revision cases, a 540 degree fusion was done, the first part an extended laminectomy and facetectomy with the patient in the prone position. The next part was the laparoscopic placement of a single ALIF type cage in the L5-S1 and in one case in the L4-L5 intervertebral spaces, and the final part of the operation, completing either a 360 or a 540 degree fusion was the posterior instrumentation implantation with graft placement. Mean operative time was 270 min. Results: Early, full mobilization was commenced in all patients. No major complication occurred during or after the surgery and within one year, solid fusion was documented in all twelve patients. A significant improvement in visual analog scale score and Oswestry disability index was documented in all patients. Conclusion: Laparoscopic lumbar interbody fusion when performed with a single, large, lordotic ALIF type cage, is an innovative technique, that in our experience led to excellent results, particularly in the demanding L5-S1 fusion cases and proved to be safe and comparable with the open fusion techniques.