Metastatic spinal tumors are common, and their rising incidence can be attributed to the expanding aging population and increased survival rates among cancer patients. The decision-making process in the treatment of spinal metastasis requires a multidisciplinary approach that includes medical and radiation oncology, surgery, and rehabilitation. Various decision-making systems have been proposed in the literature in order to estimate survival and suggest appropriate treatment options for patients experiencing spinal metastasis. However, recent advances in treatment modalities for spinal metastasis, such as stereotactic radiosurgery and minimally invasive surgical techniques, have reshaped clinical practices concerning patients with spinal metastasis, making a demand for further improvements on current decision-making systems. In this review, recent improvements in treatment modalities and the evolution of decision-making systems for metastatic spinal tumors are discussed.

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Lumbar degenerative disease is a common problem in an aging society. Oblique lateral interbody fusion (OLIF) is a minimally invasive surgical (MIS) technique that utilizes a retroperitoneal antepsoas corridor to treat lumbar degenerative disease. OLIF has theoretical advantages over other lumbar fusion techniques, such as a lower risk of lumbar plexus injury than direct lateral interbody fusion (DLIF). Previous studies have reported favorable clinical and radiological outcomes of OLIF in various lumbar degenerative diseases. The use of OLIF is increasing, and evidence on OLIF is growing in the literature. The indications for OLIF are also expanding with the help of recent technical developments, including stereotactic navigation systems and robotics. In this review, we present current evidence on OLIF for the treatment of lumbar degenerative disease, focusing on the expansion of surgical indications and recent advancements in the OLIF procedure.

Objectives Oblique lateral interbody fusion is considered a useful surgical option for various lumbar degenerative diseases with favorable clinical results and few complications. However, clinical outcomes following oblique lateral interbody fusion stratified according to the preoperative diagnosis have not been fully evaluated in a large cohort. The purpose of the present study was to evaluate the clinical outcomes following oblique lateral interbody fusion for lumbar degenerative disease and to identify differences in outcomes when stratified according to preoperative diagnosis. Methods All patients receiving oblique lateral interbody fusion for lumbar degenerative diseases were included in the current study and were stratified into four diagnostic groups: (i) degenerative spondylolisthesis; (ii) spondylolytic spondylolisthesis; (iii) spinal stenosis without spondylolisthesis and instability; and (iv) deformity. Clinical outcomes were assessed using multiple patient‐reported questionnaires. Radiologic outcomes, including cage subsidence and completion of fusion, were also evaluated. Results Overall, 169 patients with 262 operative levels were included in the study. All clinical scoring items showed significant improvement at 1 year postoperatively for all diagnostic groups. Net and percent improvement, and a proportion of patients reaching a threshold for substantial clinical benefit were not significantly different between the diagnostic groups in all scoring items, except for lower extremity radiating pain of the deformity group. Although the deformity group had the highest overall complication rate, neurologic complications were more frequent in the spondylolytic spondylolisthesis group. The rate of complete fusion and cage subsidence for individual levels at 1 year postoperatively was 62.7% and 32.6% respectively, with no significant difference between the diagnostic groups. Conclusions The large single‐institution prospective cohort of the present study showed favorable clinical outcomes following oblique lateral interbody fusion for lumbar degenerative disease, even in spinal stenosis without spondylolisthesis and instability.