Prepsoas oblique lateral lumbar interbody fusion in deformity surgery

Miller, Catherine; Gulati, Puneet; Bandlish, Deepak; Chou, Dean; Mummaneni, Praveen V.

doi:10.21037/atm.2018.03.23

Cited by 5 publications

(6 citation statements)

References 23 publications

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“…Transient thigh symptoms are always experienced postoperatively and could be as high as 62.7% in XLIF cohorts (19). For OLIF, prior studies reported rates ranging from 1.3% to 21.4% (1,13,17), but these are likely underestimated because only motor dysfunction was described and not sensory abnormalities. Adverse postoperative neurological effects are still a significant concern despite intraoperative nerve monitoring (20).…”

Section: Discussionmentioning

confidence: 99%

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Clinical results and complications associated with oblique lumbar interbody fusion technique

Cheng¹,

Wang²,

Zhang³

et al. 2021

Ann Transl Med

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Background: Oblique lumbar interbody fusion (OLIF) is a minimally invasive technique performed through the antero-oblique trajectory to address a wide range of lumbar pathologies. However, it can lead to complications. We reviewed the results of OLIF and discussed the effective methods to avoid such complications.Methods: Seventy-nine consecutive patients who underwent OLIF between May 2016 and July 2019 were retrospectively analyzed. They were divided into three groups: stand-alone, posterior, and lateral fixation, according to whether they were followed up with auxiliary internal fixation as well as the fixation methods.Preoperative and last follow-up visual analog scale (VAS) and Oswestry Disability Index (ODI) scores were used to assess the improvement in the lower back and leg pain as well as neurological conditions. We analyzed intervertebral disc height (DH), segmental lumbar lordotic angle (SLL), lumbar lordotic angle (LL), pelvic tilt (PT), pelvic incidence-lumbar lordosis (PI-LL) mismatch, and the cross-section area (CSA) on axial magnetic resonance imaging (MRI) image in different groups. Complications, including thigh symptoms, cage subsidence, neurological injury, and vascular injury, were also noted.Results: Seventy-nine patients were followed up postoperatively for 23.2±11.5 (range, 12-48) months.Forty-eight (61%) patients underwent stand-alone surgery (without fixation), 15 (19%) patients underwent supplemental percutaneous pedicle screw fixation (posterior fixation), and 16 (20%) patients underwent lateral vertebral instrumentation (lateral fixation). In all three groups, the VAS score and the ODI score had significantly decreased at the final follow-up compared to pre-operation. The DH, SLL, LL, CSA, PT, and PI-LL mismatch had also improved by final follow-up. The most common approach-related complication was thigh symptoms. Of the 79 patients, ipsilateral transient psoas paresis occurred in 9 (11.4%), ipsilateral transient quadriceps weakness in 2 (2.5%), and groin/thigh numbness and pain in 17 (21.5%). Cage subsidence occurred in 8 (10.1%) patients, including five cases of grade 0, one of grade I, and two of grade II. Three (3.8%) patients in this study had a vascular injury.Conclusions: OLIF is a minimally invasive and effective technique for dealing with degenerative lumbar diseases. However, it should also be noted that this approach carries risks of complications.

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Section: Discussionmentioning

confidence: 99%

“…Lumbar interbody arthrodesis is a safe, effective surgical procedure to treat lumbar disc herniation, degenerative disc disease, instability in lumbar spondylolisthesis, spinal deformity, and discogenic back pain. It can increase fusion rates and correct coronal and sagittal alignment (1).…”

Section: Introductionmentioning

confidence: 99%

Clinical results and complications associated with oblique lumbar interbody fusion technique

Cheng¹,

Wang²,

Zhang³

et al. 2021

Ann Transl Med

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“…The overall incidence of complications is reported to be 11.2-48.3%, including fatal abdominal aorta/iliac artery injury, segmental artery injury, peritoneal injury, lumbar myasthenia, ureteral injury, spinal nerve injury, sympathetic nerve injury, incision pain, cage subsidence (CS)/retropulsion, infection, retrograde ejaculation, etc. [5][6][7][8] . Among these complications, CS is considered to be signi cantly related to worse clinical outcomes [9] .…”

Section: Introductionmentioning

confidence: 99%

Osteoporosis Delimit the Indication for Additional Fixation in Oblique Lumbar Interbody Fusion

Cai

Luo

Zhu

et al. 2021

Preprint

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Study design: A retrospective cohort study.Objective: To detect the boundary of indications of fixation in OLIF surgery.Methods: Review patients undergoing stand-alone or combined OLIF. Measure the disc height increment (ΔDH), foraminal height (FH), cage subsidence (CS). VAS and the ODI was used to evaluate low back pain and functionality. Multiple linear regression were used to determine the risk factors of CS.Results: A totle of 66 consecutive patients included. The BMD in combined group was significantly lower than that of stand-alone group(p=0.005). The combined group showed better FH maintenance at 6 months (p= 0.049) and last follow-up (p= 0.019). In combined group, tCS was significantly lower at all post-operation point (p≤0.001). BMD was a mild negative correlated factor for CS in combined group (r= -0.602, p= 0.001)and a strongly negative correlated factor in stand-alone group (r= -0.797, p< 0.001). Greater mCS significantly associated with worse VAS (r=0.685, p<0.001) and ODI (r=0.616, p<0.001) in stand-alone group, and this effect was significantly weakened in the combined group as VAS (r=0.427, p=0.033) and ODI (r=0.594, p=0.002). Patients with stand-alone OLIF were at risk of severe CS when BMD <-1.38, while those with combined OLIF had an equal risk when BMD < -4.77.Conclusions: The long-term fusion rates and functionality improvements of OLIF with or without fixation are comparable. Patients with BMD < -1.38 may not suitable for stand-alone procedure due to higher risk of severe CS and worse clinical outcomes. Additional fixation can extends the applicable boundary to a BMD = -4.77.

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“…Early data showed that bleeding, surgical time, and postoperative recovery had favorable results. 3 Historically, lateral lumbar interbody fusion (LLIF) has been done with a true lateral view under fluoroscopy, but the OLIF is done from an oblique trajectory. 4,5 This oblique angle can be somewhat disorienting for surgeons, and navigation may be one method to help abate this disorientation.…”

Section: Introductionmentioning

confidence: 99%

The Navigated Oblique Lumbar Interbody Fusion: Accuracy Rate, Effect on Surgical Time, and Complications

Chou

Mummaneni

et al. 2020

Neurospine

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The oblique lumbar interbody fusion (OLIF) can be done with either fluoroscopy or navigation. However, it is unclear how navigation affects the overall flow of the procedure. We wished to report on the accuracy of this technique using navigation and on how navigation affects surgical time and complications. Methods: A retrospective review was undertaken to evaluate patients who underwent OLIF using spinal navigation at University of California San Francisco. Data collected were demographic variables, perioperative variables, and radiographic images. Postoperative lateral radiographs were analyzed for accuracy of cage placement. The disc space was divided into 4 quadrants from anterior to posterior, zone 1 being anterior, and zone 4 being posterior. The accuracy of cage placement was assessed by placement. Results: There were 214 patients who met the inclusion criteria. A total of 350 levels were instrumented from L1 to L5 using navigation. The mean follow-up time was 17.42 months. The mean surgical time was 211 minutes, and the average surgical time per level was 129.01 minutes. After radiographic analysis, 94.86% of cages were placed within quartiles 1 to 3. One patient (0.47%) underwent revision surgery because of suboptimal cage placement. For approach-related complications, transient neurological symptoms were 10.28%, there was no vascular injury. Conclusion: The use of navigation to perform OLIF from L1 to L5 resulted in a cage placement accuracy rate of 94.86% in 214 patients.

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Prepsoas oblique lateral lumbar interbody fusion in deformity surgery

Cited by 5 publications

References 23 publications

Clinical results and complications associated with oblique lumbar interbody fusion technique

Clinical results and complications associated with oblique lumbar interbody fusion technique

Osteoporosis Delimit the Indication for Additional Fixation in Oblique Lumbar Interbody Fusion

The Navigated Oblique Lumbar Interbody Fusion: Accuracy Rate, Effect on Surgical Time, and Complications

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