Copyright ©2013 Baishideng.
World J Clin Cases. Apr 16, 2013; 1(1): 4-12
Published online Apr 16, 2013. doi: 10.12998/wjcc.v1.i1.4
Table 1 Advantages and disadvantages of current procedures for the treatment of degenerative disorders of the lumbar spine
Surgical techniqueAdvantagesDisadvantages
ALIFDirect visualization of disc spaceIntra-abdominal vascular and visceral injury[31,32]
Small incisions and reduced tissue invasiveness if minimally invasive approach performed[27-30]
PLIFAvoiding intra-abdominal complications associated with anterior approachIncreased risk of surgical damage to neural structures, dural layer, and epidural veins[33-35]
LLIFAvoiding surgical complications associated with anterior and posterior approachesLimited surgical accessibility of L5-S1 level due to iliac crest
Sparing of anterior longitudinal ligament (ligamentotaxis)[36]Injury to lumbar plexus during transpsoas approach with post-operative approach-related neurological deficits[37-40]
Stable implantation of device due to bilateral utilization of the dense apophyseal ring[36]
TLIFMinimally-invasiveLess reduction in ROM compared to LLIF, if performed as stand-alone procedures[41]
Reduced nerve root retraction[41]
Circumferential fusion[27,41-43]
Total disc arthroplastyReduced risk of adjacent segment disease due to preservation of motion[47]Narrow spectrum of indications[48,49]
No fusion required[47]
Nucleus replacementPreservation of motionRisk of device migration, extrusion, and subsidence[53,54]
Multiple approach and revision options[53]
Sublaminar wiringCan be implanted as an adjunct to other devices (hybrid)[4]Risk of neurological injury[58,59]
Pedicle screwsInvolvement of all three columns[4]High costs[4]
Rigid segmental fixation[4]Damage to neural and vascular structures[4]
High fusion rates[4]Adjacent segment disease[62]
Adequate deformity correction[4]
Percutaneous approach possible[65-67]
Translaminar screwsMinimally-invasive percutaneous approach available[4,68,69]Not indicated for multilevel arthrodesis[4,68,69]
Facet arthroplastyPreservation of motionComplex anatomy of facet joints
Reduce the risk of adjacent segment disease[71]Narrow spectrum of indications
Interspinous implantsPreservation of motionNarrow spectrum of indications