Mini-open oblique lumbar interbody fusion (OLIF) approach for multi-level discectomy and fusion involving L5–S1: Preliminary experience

Zaïri, Fahed; Sunna, Tarek; Westwick, Harrison J.; Weil, Alexander G.; Wang, Z.; Boubez, Ghassan; Shédid, Daniel

doi:10.1016/j.otsr.2016.11.016

Cited by 45 publications

(32 citation statements)

References 19 publications

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“…In contrast to the retroperitoneal extrapsoas approach for OLIF at L2-5 (OLIF25), OLIF51 uses the corridor under the bifurcation of the great abdominal vessels 21) . This approach corridor for OLIF51 enables insertion of a cage with a greater height and angle compared with that in TLIF 3,21,22) .…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Oblique Lateral Interbody Fusion at L5–S1 Level Compared to Transforaminal Lumbar Interbody Fusion

Mun

Kim

et al. 2020

J Korean Neurosurg Soc

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The use of oblique lateral interbody fusion at the L5-S1 level (OLIF51) is increasing, but no study has directly compared OLIF51 and transforaminal lumbar interbody fusion (TLIF) at the L5-S1 level. We evaluated the usefulness of OLIF51 by comparing clinical and radiologic outcomes with those of TLIF at the same L5-S1 level. Methods : We retrospectively reviewed and compared 74 patients who underwent OLIF51 (OLIF51 group) and 74 who underwent TLIF at the L5-S1 level (TLIF51 group). Clinical outcomes were assessed with the visual analogue scale for back pain and leg pain and the Oswestry Disability Index. Mean disc height (MDH), foraminal height (FH), disc angle (DA), fusion rate, and subsidence rate were measured for radiologic outcomes. Results : The OLIF51 group used significantly higher, wider, and larger-angled cages than the TLIF51 group (p<0.001). The postoperative MDH and FH were significantly greater in the OLIF51 group than in the TLIF51 group (p<0.001). The postoperative DA was significantly larger in the OLIF51 group than in the TLIF51 group by more than 10º (p<0.001). The fusion rate was 81.1% and 87.8% at postoperative 6 months in the OLIF51 and TLIF51 groups, respectively, and the TLIF51 group showed a higher fusion rate (p<0.05). The subsidence rate was 16.2% and 25.3% in the OLIF51 and TLIF51 groups, respectively, and the OLIF51 group showed a lower subsidence rate (p<0.05). Conclusion : OLIF51 was more effective for the indirect decompression of foraminal stenosis, providing strong mechanical support with a larger cage, and making a greater lordotic angle with a high-angle cage than with TLIF.

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Section: Introductionmentioning

confidence: 99%

Usefulness of Oblique Lateral Interbody Fusion at L5–S1 Level Compared to Transforaminal Lumbar Interbody Fusion

Mun

Kim

et al. 2020

J Korean Neurosurg Soc

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“…However, one major concern for damage to the iliac vessel and its tributaries such as the iliolumbar vein, compels the surgeons to abandon the usage of OLIF at the L5-S1 level [2]. Zairi et al suggests ligating the iliolumbar vein should be prerequisite for successful access to the L5-S1 disc, with aim of reducing the incidental injury of these vulnerable structures [9]. However, it generally requires excessive dissection and manipulation with more soft tissue interference around the oblique corridor, potentially increase postoperative thigh pain and the chance of neurovascular complications.…”

Section: Discussionmentioning

confidence: 99%

“…procedure [2,9,11]. Obstruction of the iliac crest at the L5-S1 level poses some di culty for the orthogonal maneuver of the inserted instrument, which may lead to postoperative misplacement of interbody fusion cages.…”

Section: Discussionmentioning

confidence: 99%

“…With the advancement in surgical techniques and instruments, several spine surgeons attempt to perform L5-S1 interbody fusion with the OLIF technique (termed as OLIF L5-S1) [2,[6][7][8][9][10][11][12]. The usage of OLIF at the lumbosacral junction can provide larger surface area for solid fusion, reestablish anterior column support, and simultaneously achieve indirect decompression and correction of sagittal alignment.…”

Section: Introductionmentioning

confidence: 99%

“…However, the anatomic characteristics of the retroperitoneal oblique corridor to the L5-S1 disc pose technical challenges to spine surgeons, especially the complexity of neurovascular structures and disturbance of the iliac crest [2,9,11,[12][13][14]. Despite few literatures related to OLIF L5-S1 are available in recent years, OLIF L5-S1 doesn't have gained widespread acceptance in spine community as OLIF L2-5.…”

Section: Introductionmentioning

confidence: 99%

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Oblique lumbar interbody fusion at the L5-S1 segment via an approach between the psoas muscle and the great vessels: technique note and case presentations.

Diao

Zhang

et al. 2020

Preprint

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Study Design: Technique note.Objectives: To describe our modified oblique lumbar interbody fusion (OLIF) technique in the reconstruction of the L5-S1 segment.Summary of Background Data: Recently, OLIF has been generally recognized as an effective procedure in the treatment of various spinal pathologies at L2-L5 segments. However, the usage of OLIF at the L5-S1 segment doesn’t have gained widespread acceptance in spine community. Some authors still concern about the feasibility of OLIF used in lumbosacral fusion Methods: Ten consecutive patients underwent L5-S1 interbody fusion using the OLIF technique in our institution. The L5–S1 disc space is approached via one retroperitoneal oblique corridor between the psoas muscle and the great vessels. The discectomy and endplate preparation are performed through a surgical window developed on the anterolateral side of L5-S1 disc. A secondary cage insertion technique is used for safe placement of interbody fusion cages.Results: Of the 10 patients, 6 were males and 4 were females, with an average age of 55.4±6.8 years. There were 8 single-level and 2 two-level procedures, including 2 at L4–L5 and 10 at L5–S1. Preoperative axial MR images confirmed 1 patient with type I LCIV (left common iliac vein), 6 with type II LCIV and 3 with type III LCIV. The average blood loss was 133.4±88.5 ml, and the average operative times were 153.6±38.3 minutes. Postoperative radiographs examination confirmed all patients obtained a better reconstruction at the lumbosacral junction. Two patients with type III LCIV sustained iliolumbar vein laceration during the exposure, and no other perioperative complications were encountered.Conclusion: Our novel OLIF L5-S1 technique is a more feasible procedure of lumbosacral fusion, which shared the common surgical plane with OLIF L2-5, allowing for L2 to S1 reproducible multi-levels interbody fusions via a retroperitoneal oblique corridor between the psoas muscle and the great vessels. Detailed preoperative plan and meticulous intraoperative manipulation are prerequisite for the success of OLIF L5-S1 procedure.

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OLIF-Technik (Oblique Lumbar Interbody Fusion)

Scheufler

2019

Minimalinvasive Wirbelsäulenintervention

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Mini-open oblique lumbar interbody fusion (OLIF) approach for multi-level discectomy and fusion involving L5–S1: Preliminary experience

Abstract: Mini-open retroperitoneal oblique lumbar interbody fusion is feasible at the L5-S1 level with limited vascular complications through a technical modification for safe mobilization of the iliac vessels by first ligating the iliolumbar vein.

Cited by 45 publications

References 19 publications

Usefulness of Oblique Lateral Interbody Fusion at L5–S1 Level Compared to Transforaminal Lumbar Interbody Fusion

Usefulness of Oblique Lateral Interbody Fusion at L5–S1 Level Compared to Transforaminal Lumbar Interbody Fusion

Oblique lumbar interbody fusion at the L5-S1 segment via an approach between the psoas muscle and the great vessels: technique note and case presentations.

OLIF-Technik (Oblique Lumbar Interbody Fusion)

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