{"id":16544,"date":"2025-04-18T15:26:11","date_gmt":"2025-04-18T13:26:11","guid":{"rendered":"https:\/\/www.neurochirurgie-lariboisiere.com\/?p=16544"},"modified":"2025-04-18T15:49:11","modified_gmt":"2025-04-18T13:49:11","slug":"is-direct-decompression-necessary-for-lateral-lumbar-interbody-fusion-llif","status":"publish","type":"post","link":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/2025\/04\/18\/is-direct-decompression-necessary-for-lateral-lumbar-interbody-fusion-llif\/","title":{"rendered":"Is Direct Decompression Necessary for Lateral Lumbar Interbody Fusion (LLIF)?"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A Randomized Controlled Trial Comparing Direct and Indirect Decompression with LLIF in Selected Patients<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Objective:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">To compare clinical and radiological outcomes after lateral lumbar interbody fusion (LLIF), using either direct or indirect decompression, in patients with degenerative lumbar spine diseases.<br><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Methods:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Patients who underwent single-level LLIF were randomly assigned to two groups:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Group D:<\/strong> direct decompression<\/li>\n\n\n\n<li><strong>Group I:<\/strong> indirect decompression<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Clinical outcomes were measured using:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>the Oswestry Disability Index (to assess function)<\/li>\n\n\n\n<li>a visual analog scale (VAS) for back and leg pain<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Radiological outcomes included:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>cross-sectional area (CSA) of the thecal sac,<\/li>\n\n\n\n<li>disc height,<\/li>\n\n\n\n<li>foraminal height and area,<\/li>\n\n\n\n<li>fusion rate,<\/li>\n\n\n\n<li>segmental and lumbar lordosis.<br><\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Results:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">28 patients were analyzed (14 in each group), with an average age of 66.1 years. Postoperatively, both groups showed significant improvement in all clinical parameters, <strong>with no significant differences between the groups at any time point<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">All radiological outcomes were similar <strong>except<\/strong> the CSA increase, which was significantly greater in Group D (77.73 mm\u00b2 vs. 54.32 mm\u00b2; p = 0.042).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Group I<\/strong> (indirect decompression) had:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>less blood loss<\/strong> (68 mL vs. 210 mL; p &lt; 0.005)<\/li>\n\n\n\n<li><strong>shorter surgery time<\/strong> (136 min vs. 182 min; p = 0.002)<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Overall complication rates were similar in both groups.<br><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">LLIF with indirect decompression offers <strong>equivalent clinical improvements<\/strong> compared to LLIF with additional direct decompression after one year of follow-up. For properly selected patients, direct decompression may <strong>not be necessary<\/strong>, as the ligamentotaxis effect from indirect decompression seems <strong>sufficient to relieve symptoms<\/strong>, while also reducing blood loss and surgery time.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">source: <a href=\"https:\/\/www.e-neurospine.org\/journal\/view.php?number=1551\" target=\"_blank\" rel=\"noopener\">https:\/\/www.e-neurospine.org\/journal\/view.php?number=1551<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A Randomized Controlled Trial Comparing Direct and Indirect Decompression with LLIF in Selected Patients Objective: To compare clinical and radiological outcomes after lateral lumbar interbody fusion (LLIF), using either direct or indirect decompression, in patients with degenerative lumbar spine diseases&#8230;.<\/p>\n","protected":false},"author":28,"featured_media":16541,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[152],"tags":[],"class_list":["post-16544","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-neurosurgery"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/posts\/16544","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/users\/28"}],"replies":[{"embeddable":true,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/comments?post=16544"}],"version-history":[{"count":2,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/posts\/16544\/revisions"}],"predecessor-version":[{"id":16550,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/posts\/16544\/revisions\/16550"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/media\/16541"}],"wp:attachment":[{"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/media?parent=16544"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/categories?post=16544"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/tags?post=16544"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}