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Journal of Spine

ISSN: 2165-7939

Open Access

Lateral Lumbar Interbody Fusion and Neuromonitoring: A Concise Report

Abstract

Nimesha Cheruku

Lateral Lumbar Interbody Fusion (LLIF) is a widely used minimally invasive approach providing access to the disc space for interbody fusion via a lateral approach to the spine. The benefits of this procedure include shorter hospital stay and recovery time with minimal blood loss. As the approach for this procedure involves cutting through the psoas muscle, the greatest risk is to the lumbar plexus and femoral nerve which pass through the muscle. The most common post op deficits are hip flexion weakness due to quadriceps weakness and decrease in anterior thigh sensation. Intraoperative neuromonitoring (IONM) using a multi-modality approach has been shown to reduce the risk of neural injury and minimize post op deficits. Though Free run or Spontaneous Electromyography (SpEMG) and triggered EMG are commonly used during these procedures, the IONM protoc ol must be expanded to include Somatosensory Evoked Potentials (SSEP) from Saphenous nerve on the surgical side, peroneal nerve on the non-surgical side in addition to Ulnar and Posterior Tibial Nerve SSEP, Motor Evoked Potentials (MEP) from at least two muscles of the quadriceps and adductors in addition to the other lower lumbar muscles.

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