Clinical and Radiologic Outcomes of Direct Versus Indirect Decompression with Lumbar Interbody Fusion: A Matched-Pair Comparison Analysis

Lin, Guang‐Xun; Akbary, Kutbuddin; Kotheeranurak, Vit; Quillo-Olvera, Javier; Jo, Hyunjin; Yang, Xiaowei; Mahatthanatrakul, Akaworn; Kim, Jin-Sung

doi:10.1016/j.wneu.2018.08.003

Cited by 105 publications

(141 citation statements)

References 26 publications

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“…[29] Lin et al found that OLIF could achieve equivalent clinical and radiologic outcomes by indirect decompression, as compared to other posterior lumbar surgeries, while achieving better restoration of DH and causing less blood loss. [30] Chang et al also obtained favorable clinical outcomes after OLIF for lumbar spinal stenosis. [31] Consistent with the above studies, we observed signi cant improvement in clinical outcomes after OLIF and a minimum follow-up of 2 years in both our study groups (non-LBP and LBP groups), which were comparably matched in terms of demographic data and clinical outcomes.…”

Section: Discussionmentioning

confidence: 93%

Lumbar degenerative disease after oblique lateral interbody fusion:sagittal spinopelvic alignment and its impact on low back pain

Zhang

Shen

et al. 2020

Preprint

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Background: We determined the incidence and risk factors of low back pain (LBP) in patients with lumbar degenerative disease after single-level oblique lateral interbody fusion (OLIF). Methods: We retrospectively reviewed 120 lumbar degenerative disease patients who underwent single-level OLIF. We compared preoperative and postoperative radiographic parameters, including segmental lordosis (SL), lumbar lordosis (LL), disk height (DH), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), thoracic kyphosis (TK), C7-sagittal vertical axis (SVA). Clinical outcomes were evaluated using Oswestry Disability Index (ODI) scores and visual analog scale (VAS) scores for back and leg pain. All patients were followed up for at least 2 years. Results: Thirty-eight patients had postoperative LBP (VAS score for back pain ≥ 3; LBP group); the remaining 82 patients were in the non-LBP group. Age (P = 0.082), gender (P = 0.425), body mass index (P = 0.138), diagnosis (degenerative spondylolisthesis vs. lumbar spinal stenosis; P = 0.529), surgical level (P = 0.651), blood loss (P = 0.889), and operative time (P = 0.731) did not differ between the groups. In both groups, the ODI and VAS scores for back pain and leg pain significantly improved at the final follow-up compared to the preoperative scores (P = 0.003). Except for the VAS score for back pain (P = 0.000), none of the scores significantly differed between the two groups at the final follow-up (P > 0.05). In the non-LBP group, LL, SL, DH, TK, and SS significantly improved, while PT and C7-SVA significantly decreased at the final follow-up as compared to the preoperative values. In both groups, DH significantly improved postoperatively, with no significant between-group difference (P = 0.325). At the final follow-up, LL, PI-LL mismatch, PT, and C7-SVA showed significantly greater improvement in the non-LBP group than in the LBP group (P < 0.05). Multivariate analysis identified PT, PI-LL mismatch, and C7-SVA as significant risk factors for LBP after OLIF. Conclusion: OLIF for single-level lumbar degenerative disease had satisfactory clinical outcomes. PT, PI-LL mismatch, and C7-SVA were significant risk factors for postoperative LBP. Patients with appropriately decreased PT, improved C7-SVA, and PI-LL match experienced less LBP.

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Section: Discussionmentioning

confidence: 93%

Lumbar degenerative disease after oblique lateral interbody fusion:sagittal spinopelvic alignment and its impact on low back pain

Zhang

Shen

et al. 2020

Preprint

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“…And it also have better restoration of DH and less blood loss. [23] Chang et al showed favorable clinical outcomes after OLIF for the lumbar spinal stenosis. [24] Similar to their studies, we analyzed 2 groups ( Non-LBP and LBP groups) comparably matched in terms of demographic data and clinical outcomes who were treated with OLIF after a minimum 2 year followup.…”

Section: Discussionmentioning

confidence: 99%

Lumbar degenerative disease after oblique lateral interbody fusion: sagittal spinopelvic alignment and its impact on low back pain

Zhang

Shen

et al. 2020

Preprint

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Background: The objective of the retrospective study was to investigated the incidence and risk factors of low back pain (LBP) in patients with lumbar degenerative disease after single-level oblique lateral interbody fusion(OLIF).Methods: In this retrospective study, 120 patients who undergoing single-level OLIF to treat lumbar degenerative disease were recruited. Preoperative and postoperative radiographic parameters, including segmental lordosis(SL), lumbar lordosis(LL), disk height(DH), pelvic incidence(PI), pelvic tilt (PT), sacral slope(SS), thoracic kyphosis(TK), C7-sagittal vertical axis (SVA). Visual analog scale(VAS) for back and leg pain, and Oswestry Disability Index(ODI), were used to evaluate symptoms and quantify disability. All patients achieved at least two-year follow-up.Results: A total of 120 Patients who complained low back pain were apportioned to LBP group (n=38; VAS scores for back pain≥3) or Non-LBP group (n=82;VAS scores for back pain＜3). There was no difference in age(P=0.082), gender(P=0.425), body mass index(P=0.138), degenerative spondylolisthesis or lumbar spinal stenosis(P=0.529) surgical level(P=0.651), blood Loss (P=0.889) and operative time(P=0.731) between the groups. In both groups, the ODI and VAS scores for back pain and leg pain were significantly improved at the final follow-up compared to the preoperative scores (P=0.003). Furthermore, except for the LBP (P=0.000), there were no significant differences in these scores between the two groups at the final follow-up (P > 0.05). According to the radiographic parameters, in Non-LBP group, the LL, SL, DH, TK and SS had all significantly improved; PT and C7-SVA significantly decreased at the final follow-up compared to the preoperative values. The DH in both groups had significantly improved, no significant difference was found(P=0.325). In the final follow-up, LL, PI-LL, PT and C7-SVA in Non-LBP group had more improvements compared to the LBP group (P＜0.05) . Multivariate analysis showed that PT, PI-LL and C7-SVA were identified as significant risk factors for LBP after OLIF.Conclusion: The clinical outcomes of OLIF for single-level lumbar degenerative disease were satisfactory. Our findings showed that PT, PI-LL mismatch and C7-SVA had the greatest impact on the incidence of LBP. Therefore, patients with appropriate decreased PT, improved C7-SVA and PI-LL match experienced less low back pain.

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“…Previous literature also showed similar results. Lin et al [15] measured 25 patients who received OLIF with and without posterior internal fixation and found that average DH was significantly restored from 8.97 mm preoperatively to 13.44 mm postoperatively, and FH was significantly increased from a mean of 19.68 mm before surgery to 23.42 mm after surgery. In the authors' experience, the cage could be placed as far back as possible for patients with lumbar spinal stenosis so as to distract the intervertebral space to the greatest extent.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Indirect Decompression in Lumbar Spinal Stenosis with Stand-alone Oblique Lateral Interbody Fusion

Liu¹,

Zhao²,

Zhang³

et al. 2020

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Background Oblique lateral interbody fusion (OLIF) has been gained more and more attention in the treatment of degenerative lumbar disease. The goal of this study was to evaluate the effect of indirect decompression in lumbar spinal stenosis with stand-alone OLIF. Methods Sixty-three patients with lumbar spinal stenosis who underwent stand-alone OLIF between July 2017 and May 2018 our department were included. Clinical outcomes including visual analogue scale (VAS) and Oswestry Disability Index (ODI) were recorded. Radiographic outcomes comprising of disc height (DH), foraminal height (FH) and lumbar lordosis (LL) were measured. Intraoperative data and complications were collected. All the data were compared preoperatively and postoperatively. Results Eighty-two segments were fused in sixty-three patients using stand-alone OLIF. The average follow-up time was 21.9±3.5 months (range from 16 to 28 months). The DH increased from 0.9±0.3 cm preoperatively to 1.3±0.2 cm postoperatively, and the final follow-up was 1.1±0.2 cm (P < 0.01). The FH increased from 1.7±0.3 cm before surgery to 2.3±0.3 cm after surgery, but decreased to 2.1±0.3 cm at final follow-up (P < 0.01). The LL increased from 38.0°±15.6° before surgery to 42.7°±13.0° at the final follow-up (p<0.01). The VAS and ODI scores of all patients significantly improved at the final follow-up (p<0.01). The total complication rate was 30.2%. Only three patients received revision of posterior decompression and pedicle screw fixation. Conclusions Stand-alone OLIF is an effective option in selected patients with lumbar spinal stenosis.

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Clinical and Radiologic Outcomes of Direct Versus Indirect Decompression with Lumbar Interbody Fusion: A Matched-Pair Comparison Analysis

Cited by 105 publications

References 26 publications

Lumbar degenerative disease after oblique lateral interbody fusion:sagittal spinopelvic alignment and its impact on low back pain

Lumbar degenerative disease after oblique lateral interbody fusion:sagittal spinopelvic alignment and its impact on low back pain

Lumbar degenerative disease after oblique lateral interbody fusion: sagittal spinopelvic alignment and its impact on low back pain

Efficacy of Indirect Decompression in Lumbar Spinal Stenosis with Stand-alone Oblique Lateral Interbody Fusion

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