Oblique lumbar interbody fusion in management of lumbar degenerative spinal stenosis in Chinese population

Abstract

Purpose: The purpose of this study was to assess the outcomes of a cohort of local Chinese patients who underwent oblique lumbar interbody fusion (OLIF) surgery for lumbar degenerative diseases. Methods: We adopted a minimally invasive anterior approach to the lumbar spine through retroperitoneal access. In the first part of the surgery, a 3- to 5-cm left lateral incision over the abdomen was made guided by imaging. L2–L5 disc space was approached via the corridor between the left psoas muscle and the great vessels. A specially designed interbody cage filled with bone substitute was utilized for interbody fusion. In the second part of the surgery, posterior instrumentation with or without decompression, was performed in a prone position. Efficacy and safety of the surgery were studied. Results: A total of 60 patients with the mean age of 68 years underwent OLIF at 83 surgical levels. Their mean operative time was 79 min, and the average blood loss was 84 ml for the OLIF part. The mean length of hospital stay was 5.5 days. Based on plain computed tomography scan obtained at post-operative 6 months, successful fusion was achieved in 82 of the 83 surgical levels. The Oswestry Disability Index for low back pain had a mean reduction of 22.3% after 6 months. Specific complications observed include transient thigh pain or numbness, retroperitoneal hematoma, post-operative ileus and Bone Morphogenetic Protein (BMP) osteolysis. None of the patients experienced infection, symptomatic pseudo-arthrosis, hardware failure, vascular injury, nerve injury, ureteral injury, bowel injury, incisional hernia or death. Conclusion: OLIF is an effective procedure to treat lumbar spinal stenosis and spondylolisthesis with excellent fusion rate and good functional outcome. Complications specific to this procedure are not uncommon, but majority are minor and self-recovery. Proper training is required to minimize potential surgical risks.

Oblique versus Transforaminal Lumbar Interbody Fusion in Degenerative Spondylolisthesis: A Systematic Review and Meta-analysis

“…Subgroup analysis and sensitivity analysis were performed, and the result favored the OLIF group in post-operative disc height outcome. OLIF cage contributes to retaining the disc height in the following time since the OLIF technique promotes larger cage size in terms of width and height compared to the TLIF technique [31]. Furthermore, VAS improvement in back pain and leg pain was associated with the degree of deformity correction [32], [33].…”

Fusion Assessment in Stand Alone Oblique lumbar interbody fusion in Adult Degenerative Lumbar Scoliosis: A Prospective Study

“…Lumbar spine interbody fusion can certainly deal with a group of spine diseases like DDD, deformities and tumors [10] Oblique lumbar interbody fusion (OLIF) is one of the spine fusion methods used. It was implemented to take over the side effects of the commonly used interbody fusions like anterior (ALIF), lateral (LLIF) or posterior (PLIF) interbody fusio [11,12]. OLIF can obtain spinal stability, improve sagittal or coronal alignment and indirectly free the neural structures with less disadvantages related to traditional transpsoas or retropsoas approaches.…”