Lumbar Sympathetic Trunk Injury: An Underestimated Complication of Oblique Lateral Interbody Fusion

Pan, Qunlong; Yu, Haiming; He, Xiaoyu; Weng, Yiyong; Zhang, Rongmou; Wang, Hanshi; Li, Yizhong

doi:10.1111/os.13692

Cited by 3 publications

(1 citation statement)

References 25 publications

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“…In terms of postoperative complications, according to reports, postoperative complications of OLIF include abdominal organ injury, infection, lumbar sympathetic trunk injury, ureteral injury, etc. 23,24 In our cases, there was only one case of postoperative myofascial pain in the unilateral group, but the symptoms improved significantly after conservative treatment, which was consistent with the common postoperative complications of traditional percutaneous screw placement, but the positive rate was too low to be statistically significant.…”

Section: Screw Accuracysupporting

confidence: 77%

Analysis of the Screw Accuracy and Postoperative Efficacy of Screw Placement in Single Position and Bipedal Position in Robot‐Assisted Oblique Lumbar Interbody Fusion: Preliminary Results of Mazor X Stealth Usage

Zhao,

Wang,

Zhang

et al. 2023

Orthopaedic Surgery

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ObjectiveTraditional manual OLIF combined with pedicle screw implantation has many problems of manual percutaneous screw implantation, such as high difficulty of screw placement, many fluoroscopies, long operation time, and many adjustments, resulting in greater trauma. The robot can perform various types of screw placement in the lateral recumbent position, which allows OLIF combined with posterior screw placement surgery to be completed in a single position. To compare the screw accuracy and initial postoperative results of oblique anterior lumbar fusion with robot‐assisted screw placement in the lateral position and screw placement in the prone position for the treatment of lumbar spondylolisthesis.MethodsFrom May to June 2022, 45 patients with single‐segment lumbar spondylolisthesis underwent Mazor X‐assisted oblique lumbar fusion in one position and Renaissance‐assisted surgery in two different positions, and screw accuracy was assessed on computed tomography scans according to a modified Gertzbein–Robbins classification. Patients were divided into a single position group and a bipedal position group (the lateral position for complete oblique lumbar fusion and then changed to the prone position for posterior screw placement), and the perioperative parameters, including operative time, number of fluoroscopies, and operative complications, were recorded separately. The results of the clinical indicators, such as the visual analog scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI) score, were obtained.ResultsThere were no significant differences in the patients' demographic data between the two groups. The single position group had a shorter operative time and fewer fluoroscopies than the bipedal position group; the single position group had a higher percentage of screw accuracy at the A level than the bipedal position group, but there was no statistically significant difference between the two groups at the acceptable level (A + B) (p > 0.05). The single‐position group had better outcomes at the 1‐week postoperative follow‐up back pain VAS scores (p < 0.05). There was no statistically significant difference in the postoperative leg pain VAS scores or the ODI scores when compared to the control group.ConclusionRobot‐assisted lateral position oblique lumbar interbody fusion with pedicle screw placement has the same accuracy as prone positioning. Single position surgery can significantly shorten the operation time and reduce the fluoroscopy. There was no significant difference in the long‐term efficacy between the two groups.

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Section: Screw Accuracysupporting

confidence: 77%

Analysis of the Screw Accuracy and Postoperative Efficacy of Screw Placement in Single Position and Bipedal Position in Robot‐Assisted Oblique Lumbar Interbody Fusion: Preliminary Results of Mazor X Stealth Usage

Zhao,

Wang,

Zhang

et al. 2023

Orthopaedic Surgery

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Comparative analysis of tubular retractors and hook retractors in oblique lumbar interbody fusion at the initial stage of the learning curve

Gao,

Liu,

et al. 2024

J Orthop Surg Res

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Incidence and Risk Factors for Lumbar Sympathetic Chain Injury After Oblique Lumbar Interbody Fusion

Singhatanadgige,

Tangdamrongtham,

Limthongkul

et al. 2024

Neurospine

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Objective: Oblique lumbar interbody fusion (OLIF), performed using a retroperitoneal approach, can lead to complications related to the approach, such as lumbar sympathetic chain injury (LSCI). Although LSCI is a common complication of OLIF, its reported incidence varies across studies due to an absence of specific diagnostic criteria. Moreover, research on the risk factors of postoperative sympathetic chain injuries after OLIF remains limited. Therefore, this study aimed to describe the incidence, and identify independent risk factors for LSCI, in patients with degenerative lumbar spinal diseases who underwent OLIF.Methods: Between October 2020 and August 2023, a retrospective review was conducted at our institute on 200 patients who underwent OLIF at 1 to 4 consecutive spinal levels (L1–5) for degenerative spinal diseases including spinal stenosis, spondylolisthesis, degenerative scoliosis. We excluded those with infections, trauma, tumors, and lower extremity edema/warmth due to other causes. The patients were categorized into 2 groups: those with and without LSCI symptoms. Demographic data, operative data, and pre- and postoperative parameters were evaluated for their association with LSCI using a univariate logistic regression model. Variables with a p-value <0.1 in the univariate analysis were included in a multivariate model to identify the independent risk factors.Results: Thirty-five of 200 patients (17.5%) developed LSCI symptoms after OLIF. Multivariate logistic regression analysis indicated that prolonged retraction time, particularly exceeding 31.5 miniutes, remained an independent risk factor (adjusted odds ratio, 12.59; p<0.001).Conclusion: This study demonstrated that prolonged retraction time was an independent risk factor for LSCI following OLIF, particularly when it exceeded 31.5 minutes. Protecting the lumbar sympathetic chain during surgery and minimizing retraction time are crucial to avoiding LSCI following OLIF.

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Lumbar Sympathetic Trunk Injury: An Underestimated Complication of Oblique Lateral Interbody Fusion

Cited by 3 publications

References 25 publications

Analysis of the Screw Accuracy and Postoperative Efficacy of Screw Placement in Single Position and Bipedal Position in Robot‐Assisted Oblique Lumbar Interbody Fusion: Preliminary Results of Mazor X Stealth Usage

Analysis of the Screw Accuracy and Postoperative Efficacy of Screw Placement in Single Position and Bipedal Position in Robot‐Assisted Oblique Lumbar Interbody Fusion: Preliminary Results of Mazor X Stealth Usage

Comparative analysis of tubular retractors and hook retractors in oblique lumbar interbody fusion at the initial stage of the learning curve

Incidence and Risk Factors for Lumbar Sympathetic Chain Injury After Oblique Lumbar Interbody Fusion

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