Supine anterior lumbar interbody fusion versus lateral position oblique lumbar interbody fusion at L5-S1: A comparison of two approaches to the lumbosacral junction

Xi, Zhuo; Burch, Shane; Mummaneni, Praveen V.; Chang, Chih-Chang; Ruan, Huibing; Eichler, Charles M.; Chou, Dean

doi:10.1016/j.jocn.2020.10.043

Cited by 12 publications

(8 citation statements)

References 17 publications

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“…OLIF at L5–S1 using a retroperitoneal approach in the lateral decubitus position can be compared to transperitoneal ALIF performed in the supine position. OLIF is a safe and effective option for L5–S1 access and fusion, with comparable outcomes and complications to ALIF [ 73 , 74 ]. However, there are discrepancies regarding which procedure is more beneficial in restoring disc height and segmental lordosis.…”

Section: Clinical and Radiological Outcomes Of Olifmentioning

confidence: 99%

“…However, there are discrepancies regarding which procedure is more beneficial in restoring disc height and segmental lordosis. Chung et al [ 74 ] reported more significant disc height and segmental lordosis restoration in OLIF, whereas Xi et al [ 73 ] found that ALIF provided a greater disc height increase but similar postoperative segmental lordosis. We cannot derive any definite conclusion at this time from these retrospective studies with small sample sizes.…”

Section: Clinical and Radiological Outcomes Of Olifmentioning

confidence: 99%

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Pearls and Pitfalls of Oblique Lateral Interbody Fusion: A Comprehensive Narrative Review

Kim

Chang

2022

Neurospine

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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.

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Section: Clinical and Radiological Outcomes Of Olifmentioning

confidence: 99%

Section: Clinical and Radiological Outcomes Of Olifmentioning

confidence: 99%

Pearls and Pitfalls of Oblique Lateral Interbody Fusion: A Comprehensive Narrative Review

Kim

Chang

2022

Neurospine

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“…Therefore, we suggest that operation in the posterior part of the psoas muscle of CPM should be avoided in any circumstance. In fact, the LLIF of L5S1 segment was not performed through the gap between the psoas major muscle and great vessels, but from the front of the internal iliac vessels 21 , 22 .…”

Section: Discussionmentioning

confidence: 99%

A Crucial But Neglected Anatomical Factor Underneath Psoas Muscle and Its Clinical Value in Lateral Lumbar Interbody Fusion—The Cleft of Psoas Major (CPM)

Chen

2021

Orthopaedic Surgery

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Objective To describe the anatomical feature positioned beneath the psoas muscle at the lateral aspect of the lower lumbar, and to create a new location system to identify the risk factors of lateral lumbar interbody fusion. Methods Six cadavers were dissected and analyzed. The anatomy and neurovascular distribution beneath the psoas major from L3 to S1 was observed and recorded, with particular focus on the L4/5 disc and below. The psoas major surface was divided homogeneously into four parts, from the anterior border of psoas major to the transverse process. The cranial‐to‐caudal division was from the lower edge of the psoas muscle attachment on the L4 vertebrae to the upper part of the S1 vertebrae, and was divided into five segments. Then a grid system was used to create 20 grids on the psoas major surface, from the anterior border of the muscle to the transverse process and from L4 to superior S1, which was used to determine the anatomical structures' distribution and relationship beneath the psoas major. Results A cleft was identified beneath the psoas major, from the level of L4/5 downwards. It was filled with loose connective tissue and neurovascular structures. We termed it the cleft of psoas major (CPM). The sympathetic trunk, ascending lumbar vein, iliolumbar vessels, obturator nerve, femoral nerve and occasionally the great vessels are contained within the CPM, although there is significant interpersonal variation. The grid system on the psoas major surface helped to identify the anatomical structures in CPM. There was a considerably lower frequency of occurrence of neurovascular structures in the grids of I/II at the L4/5 level where can be considered the “safe zones” for the lateral lumbar interbody fusion. In contrast, the distribution of neurovascular structures at the L5S1 level is dense, where the operation risk is high. Conclusion The CPM exists lateral to the vertebral surface from L4 and below. Although the occurrence and distribution of neurovascular structures within the CPM is complex and varies greatly, it can provide a potential cavity for visualization during lateral lumbar interbody fusion. Using psoas major as a reference, this novel grid system can be used to identify the risk factors in CPM and thus identify a safe entry point for surgery.

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“…A study evaluating the position of the great vessels in relation to the anterior spine found the bifurcation of the aorta was higher whilst in the prone position; the left common iliac vessels are at greater risk whilst patients are supine [7], with the lateral decubitus position thought to aid gravity mobilise abdominal contents including the great vessels away from the operative field [44]. Indeed, efforts to mitigate approach-related complications associated with ALIF have led to a rise in the use of the oblique lumbar interbody fusion (OLIF) [33], with favourable outcomes on rates of ileus compared to ALIF [72]. With the minimally invasive approach OLIF has a vascular complication rate than that of ALIF; however, further research on its long-term outcomes is required [73].…”

Section: Patient Positioningmentioning

confidence: 99%

Is there a variance in complication types associated with ALIF approaches? A systematic review

Feeley

Clesham

et al. 2021

Acta Neurochir

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Purpose Anterior lumbar interbody fusion (ALIF) is a well-established alternative to posterior-based interbody fusion techniques, with approach variations, such as retroperitoneal, transperitoneal, open, and laparoscopic well described. Variable rates of complications for each approach have been enumerated in the literature. The purpose of this study was to elucidate the comparative rates of complications across approach type. Methods A systematic review of search databases PubMed, Google Scholar, and OVID Medline was made to identify studies related to complication-associated ALIF. PRISMA guidelines were utilised for this review. Meta-analysis was used to compare intraoperative and postoperative complications with ALIF for each approach. Results A total of 4575 studies were identified, with 5728 patients across 31 studies included for review following application of inclusion and exclusion criteria. Meta-analysis demonstrated the transperitoneal approach resulted in higher rates of retrograde ejaculation (RE) (p < 0.001; CI = 0.05–0.21) and overall rates of complications (p = 0.05; CI = 0.00–0.23). Rates of RE were higher at the L5/S1 intervertebral level. Rates of vessel injury were not significantly higher in either approach method (p = 0.89; CI = − 0.04–0.07). Rates of visceral injury did not appear to be related to approach method. Laparoscopic approaches resulted in shorter inpatient stays (p = 0.01). Conclusion Despite the transperitoneal approach being comparatively underpowered, its use appears to result in a significantly higher rate of intraoperative and postoperative complications, although confounders including use of bone morphogenetic protein (BMP) and spinal level should be considered. Laparoscopic approaches resulted in shorter hospital stays; however, its steep learning curve and longer operative time have deterred surgeons from its widespread adaptation.

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Supine anterior lumbar interbody fusion versus lateral position oblique lumbar interbody fusion at L5-S1: A comparison of two approaches to the lumbosacral junction

Cited by 12 publications

References 17 publications

Pearls and Pitfalls of Oblique Lateral Interbody Fusion: A Comprehensive Narrative Review

Pearls and Pitfalls of Oblique Lateral Interbody Fusion: A Comprehensive Narrative Review

A Crucial But Neglected Anatomical Factor Underneath Psoas Muscle and Its Clinical Value in Lateral Lumbar Interbody Fusion—The Cleft of Psoas Major (CPM)

Is there a variance in complication types associated with ALIF approaches? A systematic review

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