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Interbody Fusion Techniques in the Surgical Management of Degenerative Lumbar Spondylolisthesis

  • Treatment of Lumbar Degenerative Pathology (HJ Kim and G Mundis, section editors)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

The various lumbar interbody fusion (IBF) techniques and the evidence for their use in the treatment of degenerative lumbar spondylolisthesis (DLS) are described in this review.

Recent Findings

The existing evidence is mixed regarding the indications for and utility of IBF in DLS, but its use in the setting of pre-operative instability is most strongly supported. Anterior (ALIF), lateral (LLIF), posterior (PLIF), transforaminal (TLIF), and axial (AxiaLIF) lumbar IBF approaches have been described. While the current data are limited, TLIF may be a better option than PLIF in DLS due the increased operative morbidity and peri-operative complications observed with the latter. LLIF also appears superior to PLIF in light of improved radiologic outcomes, fewer intra-operative complications, and potentially greater improvements in disability. The data comparing LLIF to TLIF are less conclusive. No studies specifically comparing ALIF or AxiaLIF to other IBF techniques could be identified.

Summary

Instability may be the strongest indication for IBF in DLS. When IBF is employed, the authors’ preferred technique is TLIF with posterior segmental spinal instrumentation. Further research is needed.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, 60612, USA

    Peter B. Derman

  2. Hospital for Special Surgery, 535 East 71st St., New York, NY, 10021, USA

    Todd J. Albert

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Correspondence to Todd J. Albert.

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Peter B. Derman declares that he has no conflict of interest.

Todd J. Albert received royalties from DePuy and Biomet; owns stock or stock options in Vertech, In Vivo Therapeutics, Paradigm Spine, Biomerix, Breakaway Imaging, Crosstree, Invuity, Pioneer, Gentis, ASIP, and PMIG; and serves as a consultant to DePuy, Biomet, Facetlink, and Spinicity.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. This article does not contain any studies with animals performed by any of the authors.

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This article is part of the Topical Collection on Treatment of Lumbar Degenerative Pathology

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Derman, P.B., Albert, T.J. Interbody Fusion Techniques in the Surgical Management of Degenerative Lumbar Spondylolisthesis. Curr Rev Musculoskelet Med 10, 530–538 (2017). https://doi.org/10.1007/s12178-017-9443-2

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