P155. Lumbar Total Disc Replacement from a Minimally Disruptive Direct Lateral Approach: Results of the First 25 Patients

2006 ◽  
Vol 6 (5) ◽  
pp. 157S-158S ◽  
Author(s):  
Luiz Pimenta ◽  
Roberto Diaz ◽  
Luis Guerrero
Keyword(s):  
Total Disc Replacement ◽  
Lateral Approach ◽  
Disc Replacement ◽  
Lumbar Total Disc Replacement ◽  
Direct Lateral Approach

Lumbar Total Disc Replacement by the Lateral Approach—Up to 10-Year Follow-Up

2017 ◽  
Vol 17 (10) ◽  
pp. S70
Author(s):  
Luis Marchi ◽  
Luiz Pimenta ◽  
Joes Nogueira-Neto ◽  
Leonardo Oliveira ◽  
Etevaldo Coutinho ◽  
...  
Keyword(s):  
Total Disc Replacement ◽  
Lateral Approach ◽  
Disc Replacement ◽  
Lumbar Total Disc Replacement

342 Lumbar Total Disc Replacement by the Lateral Approach Up to 10-Year Follow-up

Neurosurgery ◽  
2016 ◽  
Vol 63 ◽  
pp. 200-201 ◽  
Author(s):  
Luiz Pimenta ◽  
Luis Marchi ◽  
Rodrigo Augusto Amaral ◽  
Leonardo Oliveira ◽  
Joes Nogueira-Neto ◽  
...  
Keyword(s):  
Total Disc Replacement ◽  
Lateral Approach ◽  
Disc Replacement ◽  
Lumbar Total Disc Replacement

Lumbar Total Disc Replacement by the Lateral Approach–Up to 10 Years Follow-Up

2019 ◽  
Vol 122 ◽  
pp. e325-e333 ◽  
Author(s):  
Gabriel Pokorny ◽  
Luís Marchi ◽  
Rodrigo Amaral ◽  
Rubens Jensen ◽  
Luiz Pimenta
Keyword(s):  
Total Disc Replacement ◽  
Lateral Approach ◽  
Disc Replacement ◽  
Lumbar Total Disc Replacement

Lumbar Total Disc Replacement by the Lateral Approach: Up to 10-Year Follow-Up

2016 ◽  
Vol 16 (10) ◽  
pp. S293
Author(s):  
Luis Marchi ◽  
Rodrigo A. Amaral ◽  
Etevaldo Coutinho ◽  
Fernanda Fortti ◽  
Leonardo Oliveira ◽  
...  
Keyword(s):  
Total Disc Replacement ◽  
Lateral Approach ◽  
Disc Replacement ◽  
Lumbar Total Disc Replacement

scholarly journals The Lateral Approach in Lumbar Total Disc Replacement: A Literature Review

2021 ◽  
pp. 004-010
Author(s):  
Amer Ahmad ◽  
Issa Yazan ◽  
Higginbotham Devan O ◽  
Zalikha Abdul ◽  
McCarty Scott
Keyword(s):  
Literature Review ◽  
Total Disc Replacement ◽  
Lateral Approach ◽  
Disc Replacement ◽  
Lumbar Total Disc Replacement

Lumbar total disc replacement from an extreme lateral approach: clinical experience with a minimum of 2 years' follow-up

2011 ◽  
Vol 14 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Luiz Pimenta ◽  
Leonardo Oliveira ◽  
Thomas Schaffa ◽  
Etevaldo Coutinho ◽  
Luis Marchi
Keyword(s):  
Interbody Fusion ◽  
Facet Joint ◽  
Intraoperative Complications ◽  
Total Disc Replacement ◽  
Lateral Approach ◽  
Disc Replacement ◽  
Long Term Results ◽  
Functional Improvement ◽  
Lumbar Total Disc Replacement

Object Current lumbar total disc replacement (TDR) devices require an anterior approach for implantation. This approach has inherent limitations, including risks to abdominal structures and the need for resection of the anterior longitudinal ligament (ALL). Placement of a TDR device from a true lateral (extreme lateral interbody fusion [XLIF]) approach is thought to offer a less invasive option to access the disc space, preserving the stabilizing ligaments and avoiding scarring of anterior vasculature. In this study, the authors attempted to quantify the clinical and radiographic outcomes of a lateral approach to lumbar TDR from a prospective, single-center experience. Methods A TDR device designed for implantation through a true lateral, retroperitoneal, transpsoas approach (XLIF) was implanted in 36 patients with discography-confirmed 1- or 2-level degenerative disc disease. Clinical (pain and function) and radiographic (range of motion [ROM]) data were prospectively collected preoperatively, postoperatively, and serially for a minimum of 24 months' follow-up. Results Thirty-six surgeries were performed in 16 men and 20 women (mean age 42.6 years). Surgeries included 15 single-level TDR procedures at L3–4 or L4–5, three 2-level TDR procedures spanning L3–4 and L4–5, and 18 hybrid procedures (anterior lumbar interbody fusion [ALIF]) at L5–S1 and TDR at L4–5 [17] or L3–4 [1]). Operative time averaged 130 minutes, with an average blood loss of 60 ml and no intraoperative complications. Postoperative radiographs showed good device placement. All patients were walking within 12 hours of surgery and all but 9 were discharged the next day (7 of 9 had hybrid TDR/ALIF procedures). Five patients (13.8%) had psoas weakness and 3 (8.3%) had anterior thigh numbness postoperatively, both resolving within 2 weeks. One patient (2.8%) demonstrated weakness of the leg ipsilateral to the approach side, which lasted through the 3-month visit but was resolved by the 6-month visit. One patient (2.8%) was found to have hypertrophy of the quadriceps contralateral to the approach side at the 12-month visit, which was resolved by the 2-year visit. Four patients (11%) had postoperative facet joint pain, all in hybrid cases. All patients were 2 years or more postsurgery as of this writing, although 3 were lost to follow-up between the 1- and 2-year visits. In 2 cases (5.6%), removal of the TDR device and revision to fusion were required due to unresolved pain. At 2 years' follow-up, the average visual analog scale and Oswestry Disability Index scores had improved 69.6% and 61.4%, respectively, and ROM averaged 8.6°, well within physiological norms. Conclusions Long-term results of a laterally placed TDR device demonstrate maintenance of pain relief and functional improvement. The benefits of this technique—minimal morbidity, avoiding mobilization of the great vessels, preserving the ALL, biomechanically stable orientation, and broader revision options—suggest a promising new direction for TDR procedures.

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