. 2023 May 19;10:1144699.
doi: 10.3389/fsurg.2023.1144699.
eCollection 2023.
Affiliations
Item in Clipboard
Front Surg.
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Abstract
Objective:
The oblique lateral interbody fusion (OLIF) technique is a promising interbody fusion technique. This study summarizes the technical aspects of OLIF as a salvage surgery and the preliminary outcomes of a series of cases.
Patients and methods:
A retrospective review of patients with leg or back pain induced by pseudoarthrosis or adjacent segment disease after posterior lumbar interbody fusion/transforaminal lumbar interbody fusion was done. These patients underwent salvage OLIF surgeries in our institution from January 2021 to March 2022. Variables such as the demographic, clinical, surgical, and radiological characteristics of the enrolled patients were recorded and analyzed.
Results:
Eight patients (five females and three males; mean age 69.1 ± 5.7 years, range 63-80 years) were enrolled in this study. The mean operative time was 286.25 min (range: 230-440 min), and the estimated blood loss was 90 ml (range: 50-150 ml). Only one of the eight patients experienced a complication of lower limb motor weakness, which disappeared within 5 days after surgery. The latest data showed that the mean intervertebral space height increased from 8.36 mm preoperatively to 12.70 mm and the mean segmentary lordosis increased from 8.92° preoperatively to 15.05°. Bone fusion was achieved in all but one patient, who was followed up for only 3 months. The JOA scores Japanese Orthopaedic Association (JOA) Scores for low back pain of all patients significantly improved at the final follow-up.
Conclusion:
OLIF provides a safe and effective salvage strategy for patients with failed posterior intervertebral fusion surgery. Patients effectively recovered intervertebral and foraminal height with no additional posterior direct decompression.
Keywords:
OLIF25; OLIF51; adjacent vertebral disease; failed posterior interbody fusion surgery; oblique lateral interbody fusion; salvage surgery; technical note.
© 2023 Han, Han, Meng, Zhao, Zhang, Guo, Xu, Liu, Chen, Ma and Wang.
Conflict of interest statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Figures
Figure 1
Schematic of a surgical window for OLIF2/5 and OLIF5/1.
Figure 2
Schematic diagram of an OLIF2/5 surgical incision design, separation approach, and pull hook placement (A, C, E). Schematic diagram of an OLIF5/1 surgical incision design, separation approach, and pull hook placement (B, D, F).
Figure 3
Exposure of a displaced cage from an oblique anterior view (A). Successful removal of the displaced cage was (B).
Figure 4
Preoperative frontal and lateral x-rays and CT, screw extraction, anterior slippage of a vertebral body, and cage displacement (A–C). Satisfactory repositioning of the vertebral body at 6 months postoperatively (D, E), with bone bridging seen on CT (F).
Figure 5
Preoperative frontal and lateral x-rays and CT showed bone resorption with bilateral rod fractures and pseudarthrosis formation (A–D). Postoperative images show a satisfactory reconstruction of lumbar curvature and height (E–G). A restored coronal balance (H).
References
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Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the global burden of disease study 2017. Lancet. (2018) 392(10159):1789–858. 10.1016/S0140-6736(18)32279-7
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Grant support
This work was supported by the National Natural Science Foundation of China (82100940) and the Qingdao Postdoctoral Application Research Project (2019).