Rate of Revision Surgery After Stand-alone Lateral Lumbar Interbody Fusion for Lumbar Spinal Stenosis

Study Design. Retrospective case series. Objective. To examine the reoperation rate, specifically the need for posterior decompression and/or fusion, in a cohort of patients who underwent stand-alone lateral lumbar interbody fusion for symptomatic spinal stenosis with instability or deformity. Summary of Background Data. Lateral lumbar interbody fusion provides a minimally invasive means of achieving interbody arthrodesis and indirect foraminal decompression while avoiding the potential morbidity of traditional anterior or posterior approaches. The revision rate for formal posterior decompression after isolated lateral lumbar interbody fusion for spinal stenosis is unknown. Methods. One hundred seventeen patients who underwent stand-alone lateral lumbar interbody fusion for symptomatic spinal stenosis with an indication for fusion were included in the analysis. Detailed demographic and intraoperative data were collected. Clinical evaluation was done both preoperatively and at the final follow-up, and radiographical evaluation was done preoperatively and with the first postoperative standing radiographs. Results. A total of 10.3% of patients who underwent stand-alone lateral lumbar interbody fusion ultimately required revision surgery, most commonly for persistent radiculopathy and symptomatic implant subsidence. Average time to revision was 10.8 months. There was no difference in radiographical correction between patients who did and did not require revision surgery. Conclusion. Lateral lumbar interbody fusion provides a minimally invasive means to treat lumbar spinal stenosis with an acceptable revision rate for formal posterior decompression at early follow-up.