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Lateral Approach for Spondylolisthesis

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Lateral Access Minimally Invasive Spine Surgery

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Abstract

Spondylolisthesis causing central spinal canal or neuroforaminal stenosis is one of the most common indications for lumbar decompression and fusion. Patients typically present with back and leg pain. The back pain is typically mechanical, particularly if the listhesis is mobile; the leg pain is typically radicular. Neurogenic claudication is often described in patients with central canal stenosis. Several studies have documented superior outcomes in surgical cohorts of patients with symptomatic spondylolisthesis as compared to their counterparts managed conservatively. Direct lateral, or extreme lateral, interbody fusion is a safe, minimally invasive alternative to traditional open decompression and fusion procedures to treat spondylolisthesis. Lateral interbody fusion reduces the listhesis, restores disk height, indirectly decompresses the nerve roots, and inhibits motion across an unstable segment. The nerves of the lumbosacral plexus pass through the psoas muscle fibers, and they are at risk of injury when accessing the spine using a transpsoas approach. Thigh symptoms such as numbness, pain, and weakness have been noted to be relatively common postoperatively, but these symptoms are largely transient.

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Authors and Affiliations

  1. Department of Neurological Surgery, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL, 60153, USA

    Stephen J. Johans, Paul D. Ackerman & Beejal Y. Amin MD

  2. Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA

    Paul Park

  3. Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, USA

    Junichi Ohya & Praveen V. Mummaneni

Authors
  1. Stephen J. Johans
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  2. Paul D. Ackerman
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  3. Paul Park
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  4. Junichi Ohya
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  5. Beejal Y. Amin MD
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  6. Praveen V. Mummaneni
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Corresponding author

Correspondence to Beejal Y. Amin MD .

Editor information

Editors and Affiliations

  1. University of Miami Neurological Surgery, Miami, Florida, USA

    Michael Y. Wang

  2. Spine Surgery, Weill Cornell Medical Center Hospital for Special Surgery, New York, New York, USA

    Andrew A. Sama

  3. Dept. of Neurosurgery, University of South Florida Tampa General Hospital, Tampa, Florida, USA

    Juan S. Uribe

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Johans, S.J., Ackerman, P.D., Park, P., Ohya, J., Amin, B.Y., Mummaneni, P.V. (2017). Lateral Approach for Spondylolisthesis. In: Wang, M., Sama, A., Uribe, J. (eds) Lateral Access Minimally Invasive Spine Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-28320-3_19

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  • DOI: https://doi.org/10.1007/978-3-319-28320-3_19

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-28318-0

  • Online ISBN: 978-3-319-28320-3

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