Usefulness of Oblique Lateral Interbody Fusion at L5–S1 Level Compared to Transforaminal Lumbar Interbody Fusion

Mun, Hah Yong; Ko, Myeong Jin; Kim, Young Baeg; Park, Seung Won

doi:10.3340/jkns.2018.0215

Cited by 29 publications

(28 citation statements)

References 23 publications

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“…Woods et al [ 3 ] retrospectively evaluated 137 patients who underwent the OLIF procedure, in which 10 patients who underwent OLIF51 only, and 84 patients who underwent OLIF25 combined with OLIF51; then, the author draws a conclusion that OLIF is a safe procedure at L1-5 as well as L5-S1. Mun et al [ 19 ] retrospectively reviewed and compared 74 patients who underwent OLIF51 and 74 who underwent TLIF51 and concluded that OLIF51 was more effective for indirect decompression of foraminal stenosis, providing strong mechanical support. Zairi et al [ 14 ] also showed the feasibility of accessing the L5-S1 level through the mini-open retroperitoneal approach without the need for ALIF.…”

Section: Discussionmentioning

confidence: 99%

“…Damage to LCIV is the most threatening complication associated with OLIF51 which can be very difficult to control once injured, and mobilization of these vascular structures is often a technically demanding procedure [ 15 , 23 ]. The injury to LCIV is also the most commonly complication observed in clinical practice [ 8 , 19 ]. This phenomenon is caused by the low iliocaval junction positions and the medially located LCIV, reducing the size of the operating field.…”

Section: Discussionmentioning

confidence: 99%

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Introducing V-Line as a New Strategy to Choose Surgical Corridor in Oblique Lumbar Interbody Fusion at the L5-S1 Segment

Zhang

Zhu

et al. 2021

Disease Markers

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Purpose. A retrospective imaging study assessing the availability of oblique lumbar interbody fusion at the level of L5-S1 (OLIF51) and to choose ideal surgical corridor in OLIF51 by introducing V-line. Methods. The axial views through the center of L5-S1 disc were reviewed. We adopt 18 mm as the width of the simulated surgical corridor. The midline of the surgical corridor is at the center of L5-S1 disc. According to the traction distance of the left iliac vein (LCIV) and psoas major (PM), we defined all the subjects as V (+) (traction-difficultly LCIV), V (-) (traction-friendly LCIV), P (+) (traction-difficultly PM), and P (-) (traction-friendly PM). V-line was defined as a straight line dividing equally the simulated surgical corridor. All cases were divided into 2 groups: The V-line (+) group, more than half of the LCIV region, is located in the ventral part of V-line; the V-line (-) group, more than half of the LCIV region, is located in the dorsal part of V-line. Multiple variables regressive analysis was conducted to analyze the independent risk factors of V-line (+). Results. V-line (+) was found in 36 (38.7%) patients and V-line (-) in 57 (61.3%). Incidence of V (+) and P (+) was 35.4% (33/93) and 30.1% (28/93), respectively. 16.1% (15/93) subjects processed V (+) and P (+) at the same time. The independent risk factor of V-line (+) were gender of male ( P = 0.034 , OR: 12.152) and medial position of LCIV ( P < 0.001 , OR: 265.085). High iliac crest was a significant independent protective factor ( P = 0.001 , OR: 0.750). Conclusions. Most patients were suitable for OLIF51. V-line could assess the injury risk of LCIV. For patients who are V-line (+), mainly among males having the LCIV near the midline or the iliac crest relatively low, a surgical corridor external to the LCIV should be taken into consideration.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Introducing V-Line as a New Strategy to Choose Surgical Corridor in Oblique Lumbar Interbody Fusion at the L5-S1 Segment

Zhang

Zhu

et al. 2021

Disease Markers

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show abstract

“…(3) retrospectively evaluated 137 patients who underwent OLIF procedure, in which 10 patients who underwent OLIF51 only, and 84 patients who underwent OLIF25 combined with OLIF51, then the author draws a conclusion that OLIF is a safe procedure at L1-5 as well as L5-S1. Mun et al (16) retrospectively reviewed and compared 74 patients who underwent OLIF51 and 74 who underwent TLIF51 and concluded that OLIF51 was more effective for indirect decompression of foraminal stenosis, providing strong mechanical support. Zairi et al (11) also showed the feasibility of accessing the L5-S1 level through the mini-open retroperitoneal approach without the need for ALIF.…”

Section: Application Of Olif51mentioning

confidence: 99%

“…(12,20) The injury to LCIV is also the most commonly complication observed in clinical practice. (5,16) This phenomenon is caused by the low iliocava junction positions and the medially located LCIV, reducing the size of the operating eld. According to reports in the literature, the vascular injury in the early result of OLIF was 8.6%, and it increases when the L5-S1 segment is involved.…”

Section: Simulation Of Olif51mentioning

confidence: 99%

Introducing V-line as a New Strategy to Choose Surgical Corridor in Oblique Lumbar Interbody Fusion at the L5-S1 Segment

Zhang

Zhu

et al. 2020

Preprint

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Purpose: To assess the availability of oblique lumbar interbody fusion at the level of L5-S1 (OLIF51) and to choose ideal surgical corridor in OLIF51 by introducing V-line. Methods: The axial views through the center of L5-S1 disc were reviewed. We adopt 18mm as the width of the simulated surgical corridor. The midline of the surgical corridor is at the center of L5-S1 disc. According to the traction distance of the left iliac vein (LCIV) and psoas major (PM), we defined all the subjects as V (+) (traction-difficultly LCIV), V (-) (traction-friendly LCIV), P (+) (traction-difficultly PM) and P (-) (traction-friendly PM). V-line was defined as a straight line dividing equally the simulated surgical corridor. All cases were divided into 2 groups: The V-line (+) group, more than half of the LCIV region is located in ventral part of V-line; the V-line (-) group, more than half of the LCIV region is located in dorsal part of V-line. Multiple variables regressive analysis was conducted to analyze the independent risk factors of V-line (+). Results: V-line (+) was found in 36 (38.7%) patients and V-line (-) in 57 (61.3%). Incidence of V (+) and P (+) were 35.4% (33/93) and 30.1% (28/93), respectively. 16.1% (15/93) subjects processed V (+) and P (+) at the same time. The independent risk factor of V-line (+) were gender of male (P = 0.034, OR: 12.152) and medial position of LCIV (P ＜ 0.001, OR: 265.085). High iliac crest was a significant independent protective factor (P = 0.001, OR: 0.750). Conclusions: Most patients were suitable for OLIF51. V-line could assess the injury risk of LCIV. Among male patients having the LCIV near the midline or the iliac crest relatively low, a surgical corridor external to the LCIV should be taken into consideration.

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“…Surgical treatment of pathologies at the lumbosacral junction is a common challenge in the everyday life of a spine surgeon. Anterior approaches to this junction serve as an alternative to transforaminal lumbar interbody fusion (TLIF), giving clinical, radiological, and biomechanical results superior to TLIF (Kapustka et al, 2019; Mobbs et al, 2015; Mun et al, 2020; Xu et al, 2018). The latest development in the anterior lumbar interbody fusion (ALIF) procedure is its application to the lateral position, allowing for simultaneous posterior percutaneous screw placement as a single level surgery at L5–S1, or as part of a multilevel procedure enabling surgeons to complete lumbar fusion procedures from L1 to S1 in a single lateral position (Drazin et al, 2015; Malham et al, 2019; Thomas et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Applied anatomy and surgical technique of the lateral single‐position L5–S1 fusion

et al. 2021

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The latest development in the anterior lumbar interbody fusion (ALIF) procedure is its application in the lateral position to allow for simultaneous posterior percutaneous screw placement. The technical details of the lateral ALIF technique have not yet been described. To describe the surgical anatomy relevant to the lateral ALIF approach we performed a comprehensive anatomical study. In addition, the preoperative imaging, patient positioning, planning of the skin incision, positioning of the C‐arm, surgical approach, and surgical technique are discussed in detail. The technique described led to the successful use of the lateral ALIF technique in our clinical cases. No lateral ALIF procedure needed to be aborted during these cases. Our present work gives detailed anatomical background and technical details for the lateral ALIF approach. This teaching article can provide readers with sufficient technical and anatomical knowledge to assist them in performing their first lateral ALIF procedure.

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Usefulness of Oblique Lateral Interbody Fusion at L5–S1 Level Compared to Transforaminal Lumbar Interbody Fusion

Cited by 29 publications

References 23 publications

Introducing V-Line as a New Strategy to Choose Surgical Corridor in Oblique Lumbar Interbody Fusion at the L5-S1 Segment

Introducing V-Line as a New Strategy to Choose Surgical Corridor in Oblique Lumbar Interbody Fusion at the L5-S1 Segment

Introducing V-line as a New Strategy to Choose Surgical Corridor in Oblique Lumbar Interbody Fusion at the L5-S1 Segment

Applied anatomy and surgical technique of the lateral single‐position L5–S1 fusion

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