Which factor can predict the effect of indirect decompression using oblique lumbar interbody fusion?

Woo, Joon Bum; Son, Dong-Wuk; Lee, Su-Hun; Lee, Jung Hoon; Lee, Sang Weon; Song, Geun Sung

doi:10.1097/md.0000000000029948

Cited by 4 publications

(9 citation statements)

References 19 publications

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“…The immediate enlargement of CSA of spinal canal after operation is due to the increase of intervertebral height which lead to debuckling of the ligamentum avum and posterior longitudinal ligaments. Encouragingly, Woo et al [15] retrospectively reviewed 62 patients who underwent L4/5 OLIF including 24 grade 3 patients and 16 grade 4 patients before surgery and the results directly showed only 2 patients were grade 3 and no patient was grade 4. Besides, Shimizu et al [24] had found that even if the expansion was subtle, clinical symptomatology would be resolved.…”

Section: Discussionmentioning

confidence: 99%

“…For example, Heo et al [13][14] suggested that OLIF was not suitable for patients with severe canal stenosis. On the contrary, Woo et al [15] advocated that indirect decompression principles might be applied in patients with severe spinal canal stenosis, even Schizas grade D. Besides, another study had indicated that the e ciency of OLIF for severe central stenosis was favorable [16] . Therefore, OLIF as a treatment for severe lumbar spinal stenosis is still controversial.…”

Section: Introductionmentioning

confidence: 99%

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The clinical and radiographic resuls of oblique lateral internal fusion combined with percutaneous pedicle screw fixation in the treatment of severe lumbar spinal stenosis

Liu

Gen

2023

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Backgrounds Oblique lumbar interbody fusion (OLIF) has been a popular technique for the treatment of lumbar degenerative diseases. Previous studies have shown its efficiency in lumbar spinal stenosis. But few studies have reported its application of severe lumbar spinal stenosis. The purpose the of study is to investigate the clinical and radiographic outcome of OLIF with percutaneous pedicle screws in the treatment of severe lumbar spinal stenosis. Methods Fifteen patients who underwent OLIF with percutaneous pedicle screws were retrospectively analyzed. All patients were diagnosed as severe lumbar stenosis (Schizas grade C or D) through preoperative magnetic resonance image and recieved OLIF combined with percutaneous pedicle screws surgery. Clinical outcomes including visual analogue scale (VAS)-back and and VAS-leg scores and Oswestry disability index (ODI) were evaluated before surgery and at last follow-up. Mean disc height (DH), mean foraminal height (FH), segmental lumbar lordosis (SLL) and cross-sectional area (CSA) of spinal canal were compared before and after surgery and at the last follow-up. Intraoperative data, complications and fusion rate were also investigated. Results OLIF combined with percutaneous pedicle screws was performed in 18 segments in 15 patients. Mean follow-up was 23.1 ± 4.6 months (range, 12–34 months). VAS-back, VAS-leg, and ODI scores were significantly better at last follow-up. DH increased from 8.86 ± 3.06 mm before surgery to 13.31 ± 2.14 mm after; at last follow-up, DH was 11.69 ± 1.87 mm. FH increased from 17.85 ± 2.26 mm before surgery to 22.09 ± 1.36 mm after; at last follow-up, FH was 20.41 ± 0.99 mm. CSA of spinal canal increased from 30.83 ± 21.15 mm2 before surgery to 74.99 ± 33.65 mm2 after operation and 81.22 ± 35.53 mm2 at last follow-up. The segmental LL before surgery, after surgery and at last follow-up were 20.27 ± 6.25 degrees, 20.83 ± 6.52 degrees and 19.75 ± 5.87 degrees, respectively. All patients have gained fusion at last follow-up. Conclusions OLIF with percutaneous pedicle screws could achieve satisfactory clinical and radiographic effect through indirect compression by increasing DH, FH and CSA of spinal canal, and it could be regarded as an appropriate approach for severe lumbar stenosis patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The clinical and radiographic resuls of oblique lateral internal fusion combined with percutaneous pedicle screw fixation in the treatment of severe lumbar spinal stenosis

Liu

Gen

2023

Preprint

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“…After confirming the annulotomy margin through the C-arm, annulotomy, discectomy using a shaver, contralateral annulus release, trial placement, endplate preparation, and cage insertions were performed as in conventional OLIF [ 7 , 14 ]. The contralateral annulus release process requires attention.…”

Section: Methodsmentioning

confidence: 99%

“…Endplate injury is one of the more concerning complications of OLIF, which is mainly aimed at indirect decompression [ 5 - 10 ]. In case of failure of disc height restoration owing to endplate injury, indirect decompression may be inadequate, resulting in incomplete surgical outcomes or the need for additional laminectomy [ 5 , 7 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Mini-Open Intercostal Retroperitoneal Approach for Upper Lumbar Spine Lateral Interbody Fusion

et al. 2023

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Objective: Conventional oblique lumbar interbody fusion (OLIF) approach is possible from the L2/3 to L4/5 levels. However, obstruction of the lower ribs (10th–12th) makes it difficult to maintain disc parallel maneuvers or orthogonal maneuvers. To overcome these limitations, we proposed an intercostal retroperitoneal (ICRP) approach to access the upper lumbar spine. This method does not expose the parietal pleura or require rib resection and employs a small incision.Methods: We enrolled patients who underwent a lateral interbody procedure on the upper lumbar spine (L1/2/3). We compared the incidence of endplate injury between conventional OLIF and ICRP approaches. In addition, by measuring the rib line, the difference in endplate injury according to rib location and approach was analyzed. We also analyzed the previous period (2018–2021) and the year 2022, when the ICRP has been actively applied.Results: A total of 121 patients underwent lateral interbody fusion to the upper lumbar spine (OLIF approach, 99 patients; ICRP approach, 22 patients). Endplate injuries occurred in 34 of 99 (34.3%) and 2 of 22 patients (9.1%) during the conventional and ICRP approaches, respectively (p = 0.037; odds ratio, 5.23). When the rib line was located at the L2/3 disc or L3 body, the endplate injury rate was 52.6% (20 of 38) for the OLIF approach but 15.4% (2 of 13) for the ICRP approach. Since 2022, the proportion of OLIF including L1/2/3 levels has increased 2.9-fold.Conclusion: The ICRP approach is effective in reducing the incidence of endplate injury in patients with a relatively lower rib line, without pleural exposure or rib resection.

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“…In the OLIF group, the cross-sectional area (CSA) was measured using magnetic resonance imaging (MRI) before and one week after surgery, and the results were analyzed (Fig. 3) 27) .…”

Section: Evaluation Of Clinical and Radiologic Outcomesmentioning

confidence: 99%

Outcomes and Complications of Oblique Lateral Interbody Fusion as a Surgical Option in Elderly Patients (Over 70 Years Old) with Degenerative Spinal Disease

Lee,

Son,

et al. 2023

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Objective: As Korea has become a super-aging society, the number of elderly patients with degenerative spinal disease has steadily increased. This study aimed to evaluate the usefulness of oblique lumbar interbody fusion (OLIF) by comparing the results and complications between OLIF and open spinal fusion in elderly patients with degenerative spinal disease.Methods: Thirty-one patients underwent one-level posterior lumbar interbody fusion (PLIF), and 35 patients underwent one-level indirect decompression OLIF. The clinical outcomes of the two patient groups were analyzed using the visual analog scale (VAS) and Oswestry Disability Index (ODI). Through a comparative analysis of pre- and post-operative images, we measured changes in disc height (DH) and foraminal height (FH), and investigated the occurrence of subsidence in each patient group. The cross-sectional area was measured using magnetic resonance imaging pre- and post-operatively in OLIF.Results: The pre-operative VAS and ODI scores were similar between the two groups and tended to improve post-operatively. In the OLIF group, the estimated blood loss (EBL) was significantly lower, DH and FH gains were more frequent, DH and FH maintenance was better, and cage subsidence occurred less frequently. In OLIF, psoas paresis and approach-site hematoma occurred; however, all patients with psoas paresis recovered without further treatment before discharge. In the PLIF group, dural tears occurred in four patients who recovered without revision surgery. Conclusion: OLIF enables indirect decompression, reduced EBL, shorter hospitalization, and lesser subsidence. OLIF is considered a beneficial, minimally invasive surgical method for elderly patients.

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Which factor can predict the effect of indirect decompression using oblique lumbar interbody fusion?

Cited by 4 publications

References 19 publications

The clinical and radiographic resuls of oblique lateral internal fusion combined with percutaneous pedicle screw fixation in the treatment of severe lumbar spinal stenosis

The clinical and radiographic resuls of oblique lateral internal fusion combined with percutaneous pedicle screw fixation in the treatment of severe lumbar spinal stenosis

Mini-Open Intercostal Retroperitoneal Approach for Upper Lumbar Spine Lateral Interbody Fusion

Outcomes and Complications of Oblique Lateral Interbody Fusion as a Surgical Option in Elderly Patients (Over 70 Years Old) with Degenerative Spinal Disease

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