Radiographic and Clinical Outcomes following Combined Oblique Lumbar Interbody Fusion and Lateral Instrumentation for the Treatment of Degenerative Spine Deformity: A Preliminary Retrospective Study

Abstract

Objective The authors recently used a combination of minimally invasive oblique lumbar interbody fusion (OLIF) and lateral fixation for the treatment of degenerative spine deformity. The early results were promising. Radiographic and clinical results as well as complications were retrospectively assessed in the current study. Methods Eleven patients with degenerative spine deformity underwent combined OLIF and lateral instrumentation without real-time electromyography (EMG) monitoring. Radiographic measurements including coronal Cobb angle, central sacral vertebral line (CSVL), lumbar lordosis (LL), sagittal vertebral axis (SVA), pelvic tilt (PT), and LL-PI (pelvic incidence) mismatch were taken preoperatively and at last follow-up postoperatively in all patients. Concurrently, the visual analog score (VAS) for back pain and the Oswestry Disability Index (ODI) score were used to assess clinical outcomes. The fusion rate of OLIF cage, total blood loss, operation time, hospital stay, and complications were also evaluated. Results At last follow-up, all patients who underwent combined OLIF and lateral instrumentation achieved statistically significant improvement in coronal Cobb angle (from 15.3±4.7° to 5.9±3.1°, p < 0.01), LL (from 34.3±9.0° to 48.2±8.5°, p < 0.01), PT (from 24.2±9.6° to 16.2±6.0°, p < 0.01), LL-PI mismatch (from 15.4±8.7° to 7.0±3.7°, p < 0.01), CSVL (from 2.1±2.2cm to 0.7±0.9cm, p = 0.01), and SVA (from 7.0±3.9cm to 2.9±1.8cm, p < 0.01). VAS for back pain (from 6.9±1.4 to 2.0±0.9, p < 0.05) and ODI (from 39.5±3.1 to 21.9±3.6, p < 0.01) improved significantly after surgery. Conclusions A combination of OLIF and lateral instrumentation is an effective and safety means of achieving correction of both coronal and sagittal deformity, resulting in improvement of quality of life in patients with degenerative spine deformity. It is a promising way to treat patients with moderate degenerative spine deformity.

Comparison of outcomes between indirect decompression of oblique lumbar interbody fusion and MIS-TLIF in one single-level lumbar spondylosis

“…All the parameters except thoracic kyphosis were maintained at the last follow-up. In another study by Wang et al, 11 patients with lumbar degenerative disease underwent a combination of OLIF and lateral fixation 32 . Radiographic results showed significant improvement in coronal Cobb angle from 15.3° pre-operatively to 5.9° post-operatively.…”

“…Some studies have proven indirect decompression of OLIF could attain sufficient nerve release and preserve the posterior column structures 19 , 29 , 34 – 36 . The others illustrated how OLIF with LCS is a safe and effective procedure with adequate clinical outcome and deformity correction 32 , 37 , 38 . Patients undergoing indirect decompression of OLIF with LCS in our study felt equivalent postoperative leg pain relief as them in the MIS-TLIF group.…”

Scoliosis surgery in adulthood: what challenges for what outcome?

“…It has been demonstrated that low back pain and leg pain improve and that the segmental lumbar deformity can be efficiently corrected with MIS techniques. (14,18). This strategy seems appropriate in mild and moderate ASD which present degenerative changes of the lumbar spine and a remaining curve flexibility (19).…”

Treatment of Degenerative Lumbar Scoliosis with Oblique Lumbar Interbody Fusion in Conjunction with Unilateral Pedicle Screw Fixation via the Wiltse Approach

“…Although the position of the patients needed to be changed during the operation, posterior fixation was performed under direct vision through the Wiltse approach, and long‐tailed multiaxial pedicle screws were used to reduce the difficulty of fixation to shorten the operating time and reduce the occurrence of hemorrhage. The actual operation time of this group of patients was 156.5 ± 39.5 min (85–210 min), which was almost the same as that of the patients who underwent OLIF combined with lateral fixation 27 . The treatment of lumbar degenerative diseases with OLIF combined with lateral fixation is performed with one incision, and the body position of the patient is not changed during surgery.…”