[Operative treatment of degenerative diseases of the lumbar spine].

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] 14. Nagoya J Med Sci. 2025 Aug;87(3):381-391. doi: 10.18999/nagjms.87.3.381. Current status of indirect decompression with lateral lumbar interbody fusion. Nakashima H(1), Ito S(1), Segi N(1), Ouchida J(1), Yamauchi I(1), Morita Y(1), Kanemura T(2), Imagama S(1). Author information: (1)Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. (2)Department of Orthopedic Surgery, Konan Kosei Hospital, Konan, Japan. The adoption of lumbar fusion techniques, particularly lateral lumbar interbody fusion (LLIF), has significantly evolved the management of degenerative lumbar spinal conditions. LLIF, introduced as a minimally invasive surgical procedure, offers the advantage of indirect neural decompression and robust bone fusion using large interbody cages, reducing complications such as cage subsidence and nerve injuries. Systematic reviews have indicated that LLIF was effective for foraminal decompression, although evidence regarding its effectiveness for spinal canal and lateral recess decompression remains limited. Comparisons between indirect decompression techniques like LLIF and direct methods (posterior lumbar interbody fusion and transforaminal lumbar interbody fusion) have revealed that while indirect approaches generally promoted lower surgical times and blood loss, outcomes related to pain, disability, and complications were comparable. Indirect decompression with LLIF should be approached cautiously or avoided in patients with severe stenosis or preoperative neurological impairments due to the increased risk for postoperative complications. Furthermore, meticulous surgical planning and advanced imaging techniques are essential for mitigating risks such as vascular, bowel, and ureteral injuries. Continued advancements in surgical instrumentation and navigation technologies are expected to further refine the utility of LLIF in treating complex spinal pathologies, offering a promising minimally invasive option for achieving effective spinal stabilization and decompression. DOI: 10.18999/nagjms.87.3.381 PMCID: PMC12549122