ABSTRACT
Lateral lumbar interbody fusion (LLIF) allows fusion between vertebral body end plates and indirect decompression of neural elements, and depending on the pathology, it can be done through a minimally invasive tubular retractor or, often in revision cases, through a slightly bigger incision. This technique has demonstrated promising results in patients with spondylolisthesis, degenerative scoliosis, foraminal stenosis, and adjacent segment disease. LLIF offers the advantages of a retroperitoneal approach, which keeps the abdominal viscera, sympathetic plexus, and great vessels unexposed. The anterior and posterior longitudinal ligaments are also spared, which maintains segmental stability. While the technique has gained significant popularity in recent years, there is a scarcity of literature regarding management following an unsuccessful surgery. Revision surgeries are associated with an increased risk of perioperative complications, longer postoperative stays, and greater hospital costs. In the revision setting, both altered anatomical planes and scar tissue can increase the difficulty of achieving adequate and safe exposure and maintaining the ability to execute the surgical plan. Here, we aim to provide basic guidelines for the management of revision lateral lumbar interbody fusion surgery for nonunion.
