Evaluating single-level vs. multi-level lateral lumbar interbody fusion: Clinical outcomes and complications

Abstract

Objective

Lateral Lumbar Interbody Fusion (LLIF) treats lumbar degenerative diseases (LDD) with spinal alignment and decompression advantages but can cause sensory and motor disturbances, especially in multilevel procedures. This study compares single-level and multi-level LLIF focusing on sensory and motor disturbances, surgical duration, and quality of life (QOL).

Methods

A retrospective review of 139 patients (84 males, 55 females; average age 70 years) with LDD who underwent LLIF and posterior fixation between May 2018 and January 2023 was conducted. Patients were divided into two groups: 89 patients who underwent single-level LLIF and 50 patients who underwent multi-level LLIF (two or more levels). Data on demographics, surgical details, perioperative complications, and clinical outcomes, including pain scores (Numeric Rating Scales: NRS) and QOL assessments (Japanese Orthopaedic Association Back Pain Evaluation Questionnaire: JOABPEQ), were collected preoperatively and one year postoperatively. Statistical analysis was performed to compare the outcomes between the two groups.

Results

Patients who underwent multi-level LLIF had significantly longer operative times (145.1 min vs. 98.9 min, p < 0.001) and higher estimated blood loss (126.5 mL vs. 62.9 mL, p < 0.001) compared with the single-level group. Both groups significantly improved pain intensity and QOL, including NRS and JOABPEQ score, with no significant differences in perioperative complication rates (cage subsidence, motor paralysis, thigh pain/numbness) or revision rates (4 % vs. 8 %, p = 0.396).

Conclusions

Short-term clinical outcomes suggested that both single-level and multi-level LLIF effectively improved pain and QOL outcomes in patients with LDD.