MIS-OLIF combined with anterolateral screw fixation for lumbar degenerative disc disease.

January 2, 2020

OBJECTIVE:

To introduce oblique lateral lumbar interbody fusion combined with anterolateral screw fixation (OLIF-AF) for lumbar degenerative disc disease (LDDD) and to examine the clinical efficacy and radiographic outcomes.

METHODS:

A total of 65 patients underwent single-level OLIF-AF at L2-L5 from December 2017 to August 2018. The cross-sectional area (CSA) of the thecal sac was evaluated by MRI. Disk height (DH), foraminal height (FH), and degree of upper vertebral slip (DUVS) (%) were evaluated with CT. Visual analog scale (VAS) and Oswestry Disability Index (ODI) were recorded.

RESULTS:

The VAS scores and ODI were significantly improved after surgery (p<.001). At 3 days postoperatively, the CSA improved from 93.2±14.4 mm² to 124.2±7.5 mm² (p<.001), DH increased from 9.9±1.7 mm to 12.7±1.0 mm (p<.001), left FH increased from 16.6±2.0 mm to 19.6±2.0 mm (p<.001), while the right FH increased from 16.7±2.1 mm to 19.9±2.0 mm (p<.001), and the DUVS (%) decreased from 14.2±3.1 to 4.6±2.8 (p<.001), respectively. At 12-month follow-up, these parameters have no significant difference compared with 3 days postoperatively (p>.05). Adverse events were observed in 15 (23.1%) patients, including 1(1.5%) with pain in the iliac bone donor site , left thigh pain/numbness in 2 cases (3.1%), quadriceps weakness in 2 cases (3.1%) and psoas weakness in 3 cases (4.6%), intraoperative endplate injury in 2 patients (3.1%) and cage subsidence in 5 cases (7.7%).