Is Congenital Lumbar Spinal Canal Stenosis a Contraindication for Indirect Decompression by Lateral Lumbar Interbody Fusion (LLIF)?

Abstract

Study DesignRetrospective study.ObjectivesTo assess whether the Congenital Lumbar Spinal Canal Stenosis (CLSS) affects the effectiveness of indirect decompression achieved through the Lateral Lumbar Interbody Fusion (LLIF).MethodsPatients who were categorized into 2 groups, those with CLSS (AP canal diameter <14 mm at L4 or L5) and non-CLSS, underwent OLIF at L4-5. Clinical outcomes were assessed by using the ODI and VAS pain scores. The radiographic outcomes, including disc height (DH), foraminal height, foraminal area, AP canal diameter, canal cross-sectional area (CSA), and lateral recess grading, were measured between pre- and postoperatively at the index and adjacent levels.ResultsA total of 98 patients were included (26 in CLSS and 72 non-CLSS group). Both groups showed significantly improved clinical outcomes, including ODI and VAS scores for back and leg pain at 1-month and 1-year follow-ups. Radiographically, both groups demonstrated significant increases in canal expansions at the L4-5 index level; the non-CLSS group had slightly greater absolute increases in CSA (+52.23 mm² vs +35.76 mm²) and AP canal diameter (+2.19 mm vs +1.88 mm), but not statistically significant. At the L3-4 level, statistically significant canal expansions were observed in both groups, without significant differences. At L5-S1 level, CLSS group showed significant increase in disc height (+1.02 mm vs +0.15 mm; <i>P</i> = 0.016) and foraminal area compared to non-CLSS.ConclusionWith proper patient selection, LLIF provides comparable clinical and radiographic outcomes in patients with and without CLSS. CLSS should not be considered a contraindication for LLIF.