Lumbar interbody fusion for adjacent segment disease: Illustrative cases

Publication date: Available online 6 November 2018

Source: Seminars in Spine Surgery

Author(s): Daniel G. Tobert, Heeren S. Makanji, Thomas D. Cha

Abstract

Adjacent segment disease (ASD) is a known complication of lumbar spine arthrodesis and refers to any type of deterioration at the adjacent cephalad or caudad motion segment to a prior fusion. The existing literature points to a multifactorial etiology including alterations of the physiologic biomechanics after fusion as well as the intrinsic spondylosis present at the time of the index operation. Revision posterior laminectomy and fusion can be technically challenging and has a higher complication rate than primary decompression and fusion procedures.

Lateral lumbar interbody fusion (LLIF) along with posterior extension of fusion in a hybrid technique provides a less invasive option for the surgical treatment of ASD. Adjacent level stenosis is addressed via indirect decompression of the central canal and foramina. In addition, an assortment of cages provides relative correction of coronal and sagittal plane deformity. This manuscript discusses the role of LLIF for the treatment of ASD and two illustrative cases are presented.

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