Comparison of Oblique Lumbar Interbody Fusion Combined with Posterior Decompression (OLIF-PD) and Posterior Lumbar Interbody Fusion (PLIF) in the Treatment of Adjacent Segmental Disease(ASD)

Abstract

Background: An unintended consequence following lumbar fusion is the development of adjacent segment disease (ASD). Oblique lumbar interbody fusion combined with posterior decompression (OLIF-PD) is another feasible option for ASD, and there is no literature report on this combined surgical strategy. Methods: A retrospective analysis was performed on 18 ASD patients requiring direct decompression in our hospital between September 2017 and January 2022. Among them, eight patients underwent OLIF-PD revision and ten underwent PLIF revision. There were no significant differences in the baseline data between the two groups. The clinical outcomes and complications were compared between the two groups. Results: The operation time, operative blood loss and postoperative hospital stay in the OLIF-PD group were significantly lower than those in the PLIF group. The VAS of low back pain in the OLIF-PD group was significantly better than that in the PLIF group during the postoperative follow-up. The ODI at the last follow-up in the OLIF-PD group and the PLIF group were significantly relieved compared with those before operation. The excellent and good rate of the modified MacNab standard at the last follow-up was 87.5% in the OLIF-PD group and 70% in the PLIF group. There was a statistically significant difference in the incidence of complications between the two groups. Conclusion: For ASD requiring direct decompression after posterior lumbar fusion, compared with traditional PLIF revision surgery, OLIF-PD has a similar clinical effect, but has a reduced operation time, blood loss, hospital stay and complications. OLIF-PD may be an alternative revision strategy for ASD.

Application of Oblique Lumbar Interbody Fusion augmented with lateral vertebral screw for Adjacent Segment Disease: a retrospective study

“…Several of those studies have also demonstrated the promising results of the application of OLIF in treating ASD [42][43][44]. Zhang et al compared the OLIF coupled with facet joint fusion with PLIF for revision of caudal adjacent segment disease after primary posterior lumbar fusion, and they concluded that OLIF is superior to PLIF in terms of reduced blood loss, shorter hospital stay, and lesser complications [42]. Zhu et al have compared stand-alone OLIF with PLIF in the revision of ASD.…”

Optimizing Spinal Fusion Cage Design to Improve Bone Substitute Filling on Varying Disc Heights: A 3D Printing Study

“…The OLIF technique utilizes the natural corridor between the aorta and the psoas muscle, providing direct access to the intervertebral disc space while minimizing the risk of damage to the dural sac, nerve root, posterior muscle and bony structures, thereby reducing surgical trauma and associated complications [4,5]. Furthermore, the OLIF procedure obviates the need for intraoperative neuromonitoring and is relatively straightforward, rendering it a favored surgical approach in recent years [6].…”