Oblique Lumbar Interbody Fusion with Stand-Alone Cages for the Treatment of Degenerative Lumbar Spondylolisthesis: A Retrospective Study with 1-Year Follow-Up

. 2020 Jan 11;2020:9016219.


doi: 10.1155/2020/9016219.


eCollection 2020.

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Yachong Huo et al.


Pain Res Manag.


.

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Abstract

Patients with degenerative lumbar spondylolisthesis (DLS) often suffer from years of low back pain (LBP) due to instability of the lumbar spine and the reduction of disc height. Since January 2016, we have performed oblique lateral interbody fusion (OLIF) on 154 patients. Among these, 56 patients who suffered from DLS underwent OLIF with stand-alone cages. Forty-two patients with a follow-up time that exceeded 1-year were enrolled for this study. The forty-two patients were followed up for at least one year. Operation segments ranged from L3-4 to L4-5. All the patients were with 1-level fusion. The mean postoperative ventral-disc height and dorsal-disc height increased significantly compared with preoperative (P < 0.05). A significant postoperative increase was also observed in the mean operative segmental lordotic angle and the whole lumbar lordotic angle (P < 0.05). Compared with preoperative, the postoperative VAS significantly decreased with no significant increase in the VAS in the last follow-up. The LBP was significantly relieved. The mean postoperative VAS of LBP decreased significantly compared with the preoperative ((1.6 ± 0.8) vs. (7.8 ± 0.8)). Postoperative complications included psoas major abscess and intervertebral space infection (1/56). Except for one patient whose cage subsided during the last follow-up, the other patients had good cage position. The one whose cage collapsed complained no symptoms including LBP. OLIF with stand-alone cages should be considered as a safe and effective option which can effectively alleviate LBP for the treatment of DLS.

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures


Figure 1

Figure 1

OLIF technology approach. From the space between the psoas muscle (ii) and blood vessel to the target intervertebral space (i).


Figure 2

Figure 2

Measurement method. (a) Measurement diagram of intervertebral disc height; (b) the whole lumbar lordotic angle (i) and the operative segmental lordotic angle (ii).


Figure 3

Figure 3

The comparisons of intervertebral disc height. Compared with preoperative, the height of ventral and dorsal intervertebral discs increased significantly with no loss of height at the last follow-up. P > 0.05 vs. preoperative.


Figure 4

Figure 4

The comparison of sagittal angles. Compared with preoperative, lumbar lordosis angle and segmental lordosis angle increased with no loss at the last follow-up. P > 0.05 vs. preoperative.


Figure 5

Figure 5

The comparison of the visual analogue scale. Compared with preoperative, the postoperative VAS significantly decreased with no significant increase in the VAS in the last follow-up.


Figure 6

Figure 6

The comparison of ODI. Compared with preoperative, the postoperative ODI significantly decreased. But there existed no statistical difference in ODI reduction at the last follow-up compared with postoperative.


Figure 7

Figure 7

A representative case of OLIF surgery. A patient with degenerative lumbar spondylolisthesis (L4-5, a–c) underwent OLIF surgery (d, e). One year after the operation, fusion and trabeculae were formed with the cage in a desired position (f, g).

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References

    1. Tu Z., Li L., Wang B., Li Y., Lv G., Dai Y. Stand-alone anterolateral interbody fusion versus extended posterior fusion for symptomatic adjacent-segment degeneration: a retrospective study of 2 years’ follow-up. World Neurosurgery. 2018;115:E748–E755. doi: 10.1016/j.wneu.2018.04.165.



      DOI



      PubMed

    1. Liang H. F., Liu S. H., Chen Z. X., Fei Q.-M. Decompression plus fusion versus decompression alone for degenerative lumbar spondylolisthesis: a systematic review and meta-analysis. European Spine Journal. 2017;26(12):3084–3095. doi: 10.1007/s00586-017-5200-x.



      DOI



      PubMed

    1. Silvestre C., Mac-Thiong J.-M., Hilmi R., Roussouly P. Complications and morbidities of mini-open anterior retroperitoneal lumbar interbody fusion: oblique lumbar interbody fusion in 179 patients. Asian Spine Journal. 2012;6(2):89–97. doi: 10.4184/asj.2012.6.2.89.



      DOI



      PMC



      PubMed

    1. Bohl M. A., Hlubek R. J., Turner J. D., Reece E. M., Kakarla U. K., Chang S. W. Novel surgical treatment strategies for unstable lumbar osteodiscitis: a 3-patient case series. Operative Neurosurgery. 2018;14(6):639–646. doi: 10.1093/ons/opx162.



      DOI



      PubMed

    1. Choi K. C., Ryu K. S., Lee S. H., Kim Y. H., Lee S. J., Park C. K. Biomechanical comparison of anterior lumbar interbody fusion: stand-alone interbody cage versus interbody cage with pedicle screw fixation—a finite element analysis. BMC Musculoskeletal Disorders. 2013;14(1):p. 220. doi: 10.1186/1471-2474-14-220.



      DOI



      PMC



      PubMed

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