ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Lateral lumbar interbody fusion with lateral plating: techniques, feasibility and efficacy.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Letter to the Editor concerning "Lateral lumbar interbody fusion with lateral plating: techniques, feasibility and efficacy" by T. Siu, et al. (Eur Spine J [2025]; doi: 10.1007/s00586-025-09411-w).European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
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5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeStandalone lateral lumbar interbody fusion (LLIF) enables single-position surgery and avoids the complications of posterior instrumentation though the lack of fixation may risk non-union and cage subsidence. Performing lateral plating following cage insertion may avert these untoward outcomes though the feasibility and efficacy of this approach, particularly with a four-hole plate, has been scarcely examined. The aim of this study is to review the techniques and appraise the performance of LLIF with lateral plating through analyzing a comprehensive set of clinical and radiographic case series data.
methodsA retrospective study was conducted on a series of 55 lateral plating LLIF patients with lumbar degenerative disease. Patients with significant deformity (Cobb angle > 20° and grade 2 spondylolisthesis) were excluded. Clinical outcomes were rated by patient reported outcome measures (PROMs). Non-union and cage subsidence were evaluated by computed tomography (CT) scans performed at 12 months post-surgery or beyond.
resultsA four-hole plate was successfully implanted in 65 out of 77 operative levels. The remainder had a two-hole plate inserted. Postoperative psoas weakness occurred in eight patients (15%) and thigh or groin numbness in 10 (18%). All had complete or near complete resolution at the last follow-up. Of 68 operative levels with postoperative CT available, non-union was noted in eight (12%) and cage subsidence in 14 (21%), all low grade. Significant improvement in mean PROMs scores were demonstrated in patients with non-union or cage subsidence and none required reoperation. Multivariable logistic regression analyses revealed smoking (p = 0.002) and a lack of bicortical screw purchase (p = 0.038) were significant predictors for cage subsidence.
conclusionA four-screw plating construct is a safe and feasible fixation technique for LLIF. The treatment paradigm is associated with significant improvement in PROMs and a favorable fusion rate. Low grade cage subsidence is a potential caveat though this may not translate into poorer clinical outcomes. Fixation with bicortical screws may help reduce the odds of cage subsidence.
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