Multilevel Lateral Lumbar Interbody Fusion for Symptomatic Spondylotic Stenosis and Severe Disc Degeneration Without Scoliosis: Single-Institutional Case Series and Lessons Learned

BACKGROUND: Posterior decompression for degenerative lumbar spinal stenosis (DLSS) carries approach-related morbidity. In this study, we hypothesized that multilevel lateral lumbar interbody fusion (LLIF) achieves effective indirect decompression with acceptable safety and patient-reported improvement among DLSS patients without scoliosis. METHODS: tests for parametric variables and Wilcoxon signed-rank tests otherwise. RESULTS: = 17). Overall complication rate was 40% with no major events; postoperative neurological complications included transient proximal lower-extremity weakness in 4% and persistent sensory symptoms in 12%. CONCLUSIONS: In carefully selected DLSS patients without scoliosis, multilevel LLIF achieved meaningful indirect decompression, substantial pain and disability improvement, and high early fusion rates with no major complications. The findings support LLIF as a viable alternative to posterior approaches. CLINICAL RELEVANCE: Multilevel LLIF can facilitate multilevel indirect decompression with favorable radiographic and clinical outcomes while avoiding posterior soft-tissue disruption. Routine posterior instrumentation at the index surgery may support fusion and reduce returns to the OR.