School of Medicine and Health Sciences Poster Presentations

Title

Extruded MIS Lateral Interbody Fusion Cage and Revision: A Case Report

Document Type

Poster

Keywords

Postoperative Complications; Spine; Surgical Revision; LLIF; ALIF

Publication Date

Spring 2017

Abstract

Our findings suggest that revision with an ALIF procedure after failed MIS lateral interbody fusion (LLIF) provides the proper exposure and stability to avoid recurrent cage migration. With few exceptions, the LLIF procedure is a safe and effective method of reduction for spondylolisthesis and symptoms of stenosis. Complications are rare, but include lumbar plexus injuries, anterior thigh pain, psoas weakness, retroperitoneal hernias and hematomas. There have been few reported cases of failed / extruded hardware. We report one case of an extruded LLIF cage and the subsequent treatment and revision procedures. In this case, a 70-year-old female underwent an L4-5 lateral interbody fusion for stenosis and acquired spondylolisthesis. Postoperative X-rays showed excellent placement and alignment of the cage. Three weeks after her index procedure, she complained of persistent pain and right lower extremity radicular symptoms that had consistently worsened. Repeat X-rays showed complete lateral extrusion of the cage. She returned to the operating room where she had her hardware removed anteriorly and was revised to an L4-5 anterior lumbar interbody fusion without complication, and at most recent follow up, she is asymptomatic with proper hardware positioning.

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Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

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Comments

Poster to be presented at GW Annual Research Days 2017.

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Extruded MIS Lateral Interbody Fusion Cage and Revision: A Case Report

Our findings suggest that revision with an ALIF procedure after failed MIS lateral interbody fusion (LLIF) provides the proper exposure and stability to avoid recurrent cage migration. With few exceptions, the LLIF procedure is a safe and effective method of reduction for spondylolisthesis and symptoms of stenosis. Complications are rare, but include lumbar plexus injuries, anterior thigh pain, psoas weakness, retroperitoneal hernias and hematomas. There have been few reported cases of failed / extruded hardware. We report one case of an extruded LLIF cage and the subsequent treatment and revision procedures. In this case, a 70-year-old female underwent an L4-5 lateral interbody fusion for stenosis and acquired spondylolisthesis. Postoperative X-rays showed excellent placement and alignment of the cage. Three weeks after her index procedure, she complained of persistent pain and right lower extremity radicular symptoms that had consistently worsened. Repeat X-rays showed complete lateral extrusion of the cage. She returned to the operating room where she had her hardware removed anteriorly and was revised to an L4-5 anterior lumbar interbody fusion without complication, and at most recent follow up, she is asymptomatic with proper hardware positioning.