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      EXTREME LATERAL INTERBODY FUSION IN PACIENTS WITH CHRONIC LOW BACK PAIN Translated title: FUSÃO INTERSOMÁTICA POR VIA EXTREMO LATERAL EM PACIENTES COM LOMBALGIA CRÔNICA

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          ABSTRACT

          Objective:

          To evaluate the effect of lateral lumbar interbody fusion (LLIF) or oblique interbody fusion (OLIF) on low back pain due to degenerative intervertebral disc disease.

          Methods:

          We systematically reviewed articles on surgical treatment of low back pain by LLIF and OLIF, according to the Cochrane Handbook for Systematic Reviews of Interventions. We searched through electronic databases, including Medline via PubMed, Lilacs through the Virtual Health Library (VHL), Cochrane Collaboration/Central and Cohrane/Dare Cochrane Controlled Trials Register, without language or publication date restrictions and with design for prospective cohorts and randomized clinical trials.

          Results:

          We have selected and presented three studies.

          Conclusion:

          The literature review showed great relevance in the improvement of the new surgical approach (LLIF) in relation to TLIF, but greater content availability in the databases is necessary to reach a satisfactory conclusion regarding the efficiency of the lateral approach and its advantages over other traditional procedures. Level of Evidence II, Systematic review of Level II studies.

          RESUMO

          Objetivo:

          Avaliar o efeito da técnica de fusão intersomática lateral lombar (LLIF) ou da fusão intersomática obliqua (OLIF) na lombalgia em decorrência de doença degenerativa do disco intervertebral.

          Método:

          Revisamos estudos de abordagem cirúrgica LLIF e OLIF, de acordo com o Manual Cochrane para Revisões Sistemáticas de Intervenções. A busca foi realizada, por meio de bases de dados eletrônicos, incluindo Medline via PubMed, Lilacs via Biblioteca Virtual em Saúde (BVS), Registro de ensaios Controlados da Colaboração Cochrane/Central e Cohrane/Dare, sem restrições de idiomas ou de data de publicações e com delineamento para coortes prospectivos e ensaios clínicos randomizados.

          Resultados:

          Selecionamos e apresentamos três estudos.

          Conclusão:

          Houve relevância na melhora da nova abordagem cirúrgica (LLIF) em relação à abordagem tradicional, porém é necessário maior disponibilidade de conteúdo nas bases de dados para que seja obtida conclusão quanto à eficiência da via lateral e seus benefícios em relação às demais abordagens tradicionais. Nível de Evidência II, Revisão sistemática de Estudos de Nível II.

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          Most cited references17

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          Quantifying heterogeneity in a meta-analysis.

          The extent of heterogeneity in a meta-analysis partly determines the difficulty in drawing overall conclusions. This extent may be measured by estimating a between-study variance, but interpretation is then specific to a particular treatment effect metric. A test for the existence of heterogeneity exists, but depends on the number of studies in the meta-analysis. We develop measures of the impact of heterogeneity on a meta-analysis, from mathematical criteria, that are independent of the number of studies and the treatment effect metric. We derive and propose three suitable statistics: H is the square root of the chi2 heterogeneity statistic divided by its degrees of freedom; R is the ratio of the standard error of the underlying mean from a random effects meta-analysis to the standard error of a fixed effect meta-analytic estimate, and I2 is a transformation of (H) that describes the proportion of total variation in study estimates that is due to heterogeneity. We discuss interpretation, interval estimates and other properties of these measures and examine them in five example data sets showing different amounts of heterogeneity. We conclude that H and I2, which can usually be calculated for published meta-analyses, are particularly useful summaries of the impact of heterogeneity. One or both should be presented in published meta-analyses in preference to the test for heterogeneity. Copyright 2002 John Wiley & Sons, Ltd.
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            • Article: not found

            The treatment of ruptured lumbar intervertebral discs by vertebral body fusion. I. Indications, operative technique, after care.

            R Cloward (1953)
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              • Abstract: found
              • Article: not found

              Minimally invasive anterior, lateral, and oblique lumbar interbody fusion: a literature review

              Lumbar interbody fusion involves insertion of a structural graft into an intervertebral disc space to promote bony arthrodesis. It is a well-established surgical strategy for multiple spinal disorders ranging from degenerative conditions to trauma, neoplastic diseases, and deformities requiring correction. Since the inception of lumbar interbody fusion, the most established techniques have been two posterior approaches, the posterior lumbar interbody fusion (PLIF) and the transforaminal lumbar interbody fusion (TLIF). Within the past 15 years, multiple anterolateral approaches to the spine have become widely adopted. These approaches can be performed minimally invasively and spare disruption of the paraspinal muscles and posterior spinal column while enabling wide exposure of the disc space for insertion of interbody grafts much larger than PLIF and TLIF instrumentation. This review highlights three minimally invasive anterolateral approaches: the anterior lumbar interbody fusion (ALIF), the transpsoas lateral lumbar interbody fusion (LLIF), and prepsoas or anterior to the psoas oblique lumbar interbody fusion (OLIF). Relevant topics for discussion and comparison include patient selection, surgical techniques, outcomes, and complications for the three surgical approaches.
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                Author and article information

                Journal
                Acta Ortop Bras
                Acta Ortop Bras
                aob
                Acta Ortopedica Brasileira
                ATHA EDITORA
                1413-7852
                1809-4406
                Sep-Oct 2020
                Sep-Oct 2020
                : 28
                : 5
                : 256-260
                Affiliations
                [1 ]Universidade Anhembi Morumbi, São Paulo, SP, Brazil.
                [2 ]Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
                [3 ]Universidade Federal de São Paulo, Paulista School of Medicine, Department of Orthopedics and Traumatology, São Paulo, SP, Brazil.
                Author notes
                Correspondence: Alberto Augusto Ferreira Neto. Rua Dr. Almeida Lima, 1134, Parque da Mooca, São Paulo, SP, Brazil, 03164000. alberto_f.neto@ 123456globo.com

                All authors declare no potential conflict of interest related to this article.

                AUTHORS’ CONTRIBUTIONS: Each author contributed individually and significantly to the development of this article. AAN: writing of the article, review and preparation of the entire research project; RGD: data analysis, writing of the article and preparation of the entire research project; MW: review of the article and preparation of the entire research project; DM: writing of the article, statistical analysis and review of the article.

                Author information
                http://orcid.org/0000-0003-2974-3740
                http://orcid.org/0000-0002-3258-5870
                http://orcid.org/0000-0003-1961-6537
                http://orcid.org/0000-0001-5510-3507
                Article
                10.1590/1413-785220202805233621
                7580297
                33144843
                c478d0b4-d141-422e-83c4-5716ec878b62

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 01 February 2020
                : 16 March 2020
                Page count
                Figures: 7, Tables: 4, Equations: 0, References: 16, Pages: 5
                Categories
                Systematic Review
                Spine

                low back pain,intervertebral disc,arthrodesis,dor lombar,disco intervertebral,artrodese

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