Oblique Lumbar Interbody Fusion with Stand-Alone Cages for the Treatment of Degenerative Lumbar Spondylolisthesis: A Retrospective Study with 1-Year Follow-Up

Abstract

Patients with degenerative lumbar spondylolisthesis (DLS) often suffer from years of low back pain (LBP) due to instability of the lumbar spine and the reduction of disc height. Since January 2016, we have performed oblique lateral interbody fusion (OLIF) on 154 patients. Among these, 56 patients who suffered from DLS underwent OLIF with stand-alone cages. Forty-two patients with a follow-up time that exceeded 1-year were enrolled for this study. The forty-two patients were followed up for at least one year. Operation segments ranged from L3-4 to L4-5. All the patients were with 1-level fusion. The mean postoperative ventral-disc height and dorsal-disc height increased significantly compared with preoperative (P<0.05). A significant postoperative increase was also observed in the mean operative segmental lordotic angle and the whole lumbar lordotic angle (P<0.05). Compared with preoperative, the postoperative VAS significantly decreased with no significant increase in the VAS in the last follow-up. The LBP was significantly relieved. The mean postoperative VAS of LBP decreased significantly compared with the preoperative ((1.6 ± 0.8) vs. (7.8 ± 0.8)). Postoperative complications included psoas major abscess and intervertebral space infection (1/56). Except for one patient whose cage subsided during the last follow-up, the other patients had good cage position. The one whose cage collapsed complained no symptoms including LBP. OLIF with stand-alone cages should be considered as a safe and effective option which can effectively alleviate LBP for the treatment of DLS.

Pearls and Pitfalls of Oblique Lateral Interbody Fusion: A Comprehensive Narrative Review

“…Although few studies advocate the stand-alone OLIF procedure as a safe and effective option for lumbar degenerative diseases [ 23 , 24 ], multiple biomechanical studies have shown that additional stabilization is beneficial for the stability of the OLIF construct [ 25 , 26 ]. In these studies, stand-alone OLIF without additional fixation could not provide sufficient stability to avoid cage subsidence.…”

Single-stage debridement via autogenous iliac bone graft through the OLIF corridor and lateral fixation in treating spontaneous single-level lumbar pyogenic spondylodiscitis

“…2 cases (16.6%) developed left-sided transient thigh pain/numbness and the symptom diminished 2 weeks after surgery. Consistently, it is reported that the incidence of transient thigh pain/numbness occurred in 8.3–20.4% and permanent thigh pain/numbness occurred in 4–5% in these cases treated with OLIF [ 30 – 33 ]. Thus, the bone grafts in all patients were fused within 12 months after surgery, which was comparable to the results presented in previous reports [ 34 , 35 ].…”

Effect of pedicle-screw rod fixation on oblique lumbar interbody fusion in patients with osteoporosis: a retrospective cohort study

“…The postoperative VAS and ODI scores decreased significantly in each group and were all maintained well in whole follow-up period. Immediate postoperatively, the VAS score of the stand-alone group was slightly better than that of the combined group (3 [ 3 , 4 ] vs 4 [ 3 , 5 ], p = 0.012). However, the VAS score in the combined group was better than that in the stand-alone group 3 months after the operation (3 [1.5, 3] vs 3 [ 2 , 4 ], p= 0.038).…”