Laterale thorakolumbale interkorporelle Fusion für traumatische Frakturen (Trauma-LLIF) – Technikbeschreibung und Zusammenfassung der wissenschaftlichen Evidenz

Thoracolumbar A3 and A4 fractures involving the anterior column are at greater risk of correction loss and implant failure than with stand-alone posterior fixation. The LLIF technique, established in degenerative spine surgery, may offer advantages in selected trauma cases.We describe the surgical technique and our own experience with it. A retrospective single centre cohort study included 61 neurologically intact patients with thoracolumbar fractures (T10-L3) treated over 12 years using circumferential surgery (posterior + LLIF). The anterior reconstruction was performed either primarily or secondarily via retroperitoneal (lumbar) or transthoracic (thoracic) approaches. Primary endpoints were segmental correction, fusion, complications, and clinical outcome.Segmental Cobb angle significantly improved (preoperative 14.6°, postoperative 6.7°, final follow-up 8.1°; p < 0.001). The fusion rate was 98.4%. The overall complication rate was moderate (18%), mostly related to the posterior approach. According to MacNab criteria, 95.1% of patients achieved a good or excellent outcome. No adjacent segment degeneration was observed.LLIF provides a reliable anterior reconstruction in unstable thoracolumbar fractures, with good correction maintenance, high fusion rates, and favourable clinical results. It may be a valuable addition to posterior instrumentation in selected trauma cases.