Oblique lateral interbody fusion stand-alone vs. combined with percutaneous pedicle screw fixation in the treatment of discogenic low back pain

Wang, Weiheng; Xiao, Bing; Wang, Haotian; Qi, Junqiang; Gu, Xin; Yu, Jingjing; Ye, Xiaojian; Xu, Guohua; Xi, Yanhai

doi:10.3389/fsurg.2022.1013431

Cited by 8 publications

(5 citation statements)

References 50 publications

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“…However, based on the clinical outcomes data obtained from patients three months post-operation, it is evident that UPSF group experience noticeably worse leg/back pain symptoms and functional improvement compared to BPSF group, with four individuals experiencing thigh numbness and one patient exhibiting lumbar muscle weakness. The outcome differs from previous retrospective studies, potentially attributed to the inclusion of participants specifically selected for their osteoporotic characteristics in this particular study [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 84%

Oblique lateral interbody fusion combined with unilateral versus bilateral posterior fixation in patients with osteoporosis

Ma,

Lin,

Wang

et al. 2023

J Orthop Surg Res

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Purpose To compare the clinical efficacy of oblique lateral interbody fusion (OLIF) combined with unilateral (UPSF) and bilateral pedicle screw internal fixation (BPSF) in patients with osteoporosis. Methods Clinical data of 57 patients who underwent single-segment OLIF surgery with a clear diagnosis of osteoporosis from December 2018 to May 2021 were retrospectively analyzed, of which 27 patients underwent OLIF + UPSF and 30 patients underwent OLIF + BPSF. Surgical technique-related indexes were recorded, including operative time, operative blood loss and postoperative hospital stay; clinical outcome-related indexes included postoperative complications, Visual analogue scale (VAS) and Oswestry disability index (ODI) at preoperative, 1 week, 1 month, 3 months, and 12 months postoperative follow-up; and imaging outcome-related indexes included the measurement of preoperative and postoperative segmental lordosis (SL), and observation of the degree of cage subsidence and bone graft fusion. Results The surgery was successfully performed in 57 patients, and there was no statistical difference in operative blood loss and postoperative hospital stay between UPSF group and BPSF group (P > 0.05). In terms of operative time, there was a significant difference (UPSF group: 92.30 ± 11.03 min, BPSF group: 119.67 ± 16.41, P < 0.05). Postoperative VAS and ODI scores exhibited significant improvement (P < 0.05). At the 12 months postoperative follow-up, the VAS and ODI scores in the BPSF group were significantly better than those in the UPS group (P < 0.05). Compared with the preoperative images, the SL was significantly improved in both groups after surgery (P < 0.05). At 6 months postoperatively, the fusion rate in the UPSF group was significantly lower than that in the BPSF group (P < 0.05). At 1 year postoperatively, the fusion rate in the UPSF group was not significantly different from that in the BPSF group (P > 0.05). At 1 year postoperatively, the rate and degree of cage subsidence was higher in the UPSF group than in the BPSF group (P < 0.05). Conclusion In the long term, OLIF combined with bilateral posterior fixation applied to the osteoporosis patients is superior to OLIF surgery combined with unilateral posterior fixation in terms of clinical and imaging outcomes. It is effective in improving pain relief and functional improvement, accelerating bone graft fusion, and reducing cage subsidence compared with UPSF.

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Section: Discussionmentioning

confidence: 84%

Oblique lateral interbody fusion combined with unilateral versus bilateral posterior fixation in patients with osteoporosis

Ma,

Lin,

Wang

et al. 2023

J Orthop Surg Res

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“…In the past two decades, minimally invasive spine surgery has made significant progress, attracting great interest from surgeons and patients [ 27 ]. OLIF was first proposed by Silvestre in 2012 and has been increasingly used by spinal surgeons, and research on OLIF is also growing rapidly [ 28 , 29 ]. Endplate injury and cage subsidence after OLIF are important predictors of postoperative revision, which have also plagued surgeons and patients and cannot be ignored.…”

Section: Discussionmentioning

confidence: 99%

“…As for the two mainstream surgical methods, stand-alone OLIF and OLIF + BPSF, a lot of clinical follow-up work has been done. Compared with OLIF + BPSF, stand-alone OLIF can significantly reduce the operation time, blood loss, operation cost and avoid lumbar and back muscle injury, and can significantly improve the early clinical effect after operation was no significant difference in long-term clinical and radiological results [ 29 , 34 ]. Zeng et al [ 35 ] followed up 235 patients undergoing OLIF, of which 22 patients had endplate injury and 18 patients had cage subsidence and lateral displacement.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical differences between two different shapes of oblique lumbar interbody fusion cages on whether to add posterior internal fixation system: a finite element analysis

Liu,

Geng,

Wang

et al. 2023

J Orthop Surg Res

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Background Oblique lateral lumbar fusion (OLIF) is widely used in spinal degeneration, deformity and other diseases. The purpose of this study was to investigate the biomechanical differences between two different shapes of OLIF cages on whether to add posterior internal fixation system, using finite element analysis. Methods A complete three-dimensional finite element model is established and verified for L3–L5. Surgical simulation was performed on the verified model, and the L4–L5 was the surgical segment. A total of the stand-alone group (Model A1, Model B1) and the BPSF group (Model A2, Model B2) were constructed. The four OLIF surgical models were: A1. Stand-alone OLIF with a kidney-shaped Cage; B1. Stand-alone OLIF with a straight cage; A2. OLIF with a kidney-shaped cage + BPSF; B2. Stand-alone OLIF with a straight cage + BPSF, respectively. The differences in the range of motion of the surgical segment (ROM), equivalent stress peak of the cage (ESPC), the maximum equivalent stress of the endplate (MESE) and the maximum stress of the internal fixation (MSIF) were compared between different models. Results All OLIF surgical models showed that ROM declines between 74.87 and 96.77% at L4–L5 operative levels. The decreasing order of ROM was Model A2 > Model B2 > Model A1 > Model A2. In addition, the ESPC and MESE of Model A2 are smaller than those of other OLIF models. Except for the left-bending position, the MSIF of Model B2 increased by 1.51–16.69% compared with Model A2 in each position. The maximum value of MESE was 124.4 Mpa for Model B1 in the backward extension position, and the minimum value was 7.91 Mpa for Model A2 in the right rotation. Stand-alone group showed significantly higher ROMs and ESPCs than the BPSF group, with maximum values of 66.66% and 70.59%. For MESE, the BPSF group model can be reduced by 89.88% compared to the stand-alone group model. Conclusions Compared with the traditional straight OLIF cage, the kidney-shaped OLIF cage can further improve the stability of the surgical segment, reduce ESPC, MESE and MSIF, and help to reduce the risk of cage subsidence.

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“…Interestingly, a recent biomechanical study suggests that stand-alone anterior cages can be considered for an alternative treatment of ASD, but in case of severe instability, the circumferential approach seems to provide the most biomechanically stable construct [48]. In addition, several biomechanical studies suggest that the addition of a posterior instrumentation improves the stability and rigidity of the construction and reduces the risk of complications [49][50][51][52].…”

Section: Discussionmentioning

confidence: 99%

Stand-Alone Oblique Lumbar Interbody Fusion (OLIF) for the Treatment of Adjacent Segment Disease (ASD) after Previous Posterior Lumbar Fusion: Clinical and Radiological Outcomes and Comparison with Posterior Revision Surgery

Miscusi

Trungu

Ricciardi

et al. 2023

JCM

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Background: Radiological evidence of adjacent segment disease (ASD) has been reported to have a prevalence of more than 30% and several risk factors have been reported. The aim of this study is to evaluate the clinical and radiological outcomes of patients with symptomatic ASD treated with stand-alone OLIF and compare results with a posterior revision surgery cohort. Methods: This is a retrospective case-control study. Clinical-patient-reported outcomes were obtained at preoperative, postoperative and final follow-up visits using the Short Form (SF-36) scale, the Oswestry Disability Index (ODI) and the visual analog scale (VAS). Radiological measures include lumbar lordosis (LL), segmental lordosis (SL), pelvic incidence-lumbar lordosis (PI-LL) mismatch, segmental coronal Cobb angle and intervertebral disc height (DH). The data are compared with a retrospective series of patients that underwent a posterior revision surgery for ASD. Results: Twenty-eight patients in the OLIF group and 25 patients in the posterior group meet inclusion criteria. The mean ages at the time of the surgery are 65.1 years and 67.5, respectively. The mean follow-up time is 36.1 months (range of 14–56). The clinical outcomes significantly improve from preoperative values from the surgery in both groups. The radiological parameters are significantly improved postoperatively and were maintained at the last follow-up in both groups. A statistically significant difference is observed between the two groups for minor complication rate, length of surgery, blood loss and DH restoration. Conclusions: Stand-alone OLIF is an effective and safe technique with low morbidity and complication rates for the treatment of selected patients with symptomatic ASD following a previous lumbar fusion.

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Oblique lateral interbody fusion stand-alone vs. combined with percutaneous pedicle screw fixation in the treatment of discogenic low back pain

Cited by 8 publications

References 50 publications

Oblique lateral interbody fusion combined with unilateral versus bilateral posterior fixation in patients with osteoporosis

Oblique lateral interbody fusion combined with unilateral versus bilateral posterior fixation in patients with osteoporosis

Biomechanical differences between two different shapes of oblique lumbar interbody fusion cages on whether to add posterior internal fixation system: a finite element analysis

Stand-Alone Oblique Lumbar Interbody Fusion (OLIF) for the Treatment of Adjacent Segment Disease (ASD) after Previous Posterior Lumbar Fusion: Clinical and Radiological Outcomes and Comparison with Posterior Revision Surgery

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