scholarly journals Comparison of outcomes between indirect decompression of oblique lumbar interbody fusion and MIS-TLIF in one single-level lumbar spondylosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shih-Feng Hung ◽  
Jen-Chung Liao ◽  
Tsung-Ting Tsai ◽  
Yun-Da Li ◽  
Ping-Yeh Chiu ◽  
...  
Keyword(s):  
Blood Loss ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Minimal Invasive ◽  
Lumbar Interbody Fusion ◽  
Single Level ◽  
Coronal Imbalance ◽  
Indirect Decompression ◽  
Oblique Lumbar Interbody Fusion ◽  
Segmental Lordosis

AbstractMinimal invasive spinal fusion has become popular in the last decade. Oblique lumbar interbody fusion (OLIF) is a relatively new surgical technique and could avoid back muscle stripping and posterior complex destruction as in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Between December 2016 and September 2018, patients with single level degenerative spondylosis were selected to enroll in this retrospective study. A total of 21 patients that underwent OLIF and 41 patients that received MIS-TLIF were enrolled. OLIF showed significantly less blood loss and shorter surgery time compared to MIS-TLIF (p < 0.05). The improvement in segmental lordosis and coronal balance was significantly more in OLIF group than MIS-TLIF group (p < 0.05). When comparing with MIS-TLIF, OLIF was significantly better in Oswestry Disability Index (ODI) and visual analogue scale for back pain improvement at post-operative 6 months (p < 0.05). Both OLIF and MIS-TLIF are becoming mainstream procedures for lumbar degenerative-related disease, especially for spondylolisthesis. However, the indirect decompression of OLIF has shown to have less perioperative blood loss and shorter surgery time than that of MIS-TLIF. In addition, OLIF gives superior outcome in restoring segmental lordosis and coronal imbalance. While both OLIF and MIS-TLIF provide optimal clinical outcomes, upon comparison between the two techniques, the indirect decompression of OLIF seems to be a superior option in modern days.

scholarly journals Comparison of Outcomes between Indirect Decompression of Oblique Lumbar Interbody Fusion and MIS-TLIF in One Single-level Lumbar Spondylosis: a case control study

2020 ◽  
Author(s):  
Shih-Feng Hung ◽  
Jen-chung Liao ◽  
Tsung-Ting Tsai ◽  
Yun-Da Li ◽  
Ping-Yeh Chiu ◽  
...  
Keyword(s):  
Blood Loss ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Minimal Invasive ◽  
Anterolateral Approach ◽  
Lumbar Interbody Fusion ◽  
Single Level ◽  
Study Results ◽  
Indirect Decompression ◽  
Oblique Lumbar Interbody Fusion

Abstract Background Minimal invasive spinal fusion has become popular in the last decade. Oblique lumbar interbody fusion (OLIF) is a relatively new surgical technique and could avoid back muscle stripping and posterior complex destruction as in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Methods Between December 2016 and September 2018, patients with single level degenerative spondylosis were selected to enroll in this retrospective study. Results A total of 21 patients that underwent OLIF and 41 patients that received MIS-TLIF were enrolled. OLIF showed significantly less blood loss and shorter surgery time compared to MIS-TLIF (p < 0.05). The improvement in segmental lordosis and coronal balance was significantly more in OLIF group than MIS-TLIF group (p < 0.05). When comparing with MIS-TLIF, OLIF was significantly better in Oswestry Disability Index (ODI) and visual analogue scale for back pain improvement at post-operative 6 months (p < 0.05). Conclusions Both OLIF and MIS-TLIF are becoming a mainstream procedure for lumbar degenerative-related disease, especially for spondylolisthesis. However, OLIF has shown to have less perioperative blood loss and shorter surgery time than that of MIS-TLIF. In addition, OLIF gives superior clinical and radiographic outcomes. While both OLIF and MIS-TLIF provide optimal clinical outcomes, upon comparison between the two techniques, the anterolateral approach of OLIF seems to be a superior option in modern day.

Minimally invasive microendoscopy-assisted transforaminal lumbar interbody fusion with instrumentation

2005 ◽  
Vol 3 (2) ◽  
pp. 98-105 ◽  
Author(s):  
Robert E. Isaacs ◽  
Vinod K. Podichetty ◽  
Paul Santiago ◽  
Faheem A. Sandhu ◽  
John Spears ◽  
...  
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Interbody Fusion ◽  
Pedicle Screws ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Hospital Length Of Stay ◽  
Lumbar Interbody Fusion ◽  
Intraoperative Blood Loss ◽  
Disc Space ◽  
Single Level

Object The authors have developed a novel technique for percutaneous fusion in which standard microendoscopic discectomy is modified. Based on data obtained in their cadaveric studies they considered that this minimally invasive interbody fusion could be safely implemented clinically. The authors describe their initial experience with a microendoscopic transforaminal lumbar interbody fusion (METLIF) technique, with regard to safety in the placement of percutaneous instrumentation, perioperative morbidity, and early postoperative results. Methods The METLIF procedure was performed unilaterally in 20 patients with single-level lumbar spondylolisthesis or pure mechanical back pain with endoscopic assistance, hemilaminectomy, unilateral facetectomy, and microdiscectomy. Two interbody grafts were placed via the lateral exposure of the disc space. Bilateral percutaneous pedicle screws were then inserted. Compared with patients who had undergone single-level posterior LIF at the same institutions, intraoperative blood loss, hospital length of stay (LOS), and postoperative narcotic agent use were significantly lower in the METLIF group. The mean LOS for the percutaneous fusion group was 3.4 days (5.1 days in those who underwent PLIF; p < 0.02). There have been no procedure-related complications in this series to date. Conclusions The METLIF technique provided an option for percutaneous interbody fusion similar to that in open surgery while minimizing destruction to adjacent tissues. This technique was safe and exhibited a trend toward decreased intraoperative blood loss, postoperative pain, total narcotic use, and the risk of transfusion.

Expandable vs Static Cages in Transforaminal Lumbar Interbody Fusion: Radiographic Comparison of Segmental and Lumbar Sagittal Angles

Neurosurgery ◽  
2017 ◽  
Vol 81 (1) ◽  
pp. 69-74 ◽  
Author(s):  
Timothy J. Yee ◽  
Jacob R. Joseph ◽  
Samuel W. Terman ◽  
Paul Park
Keyword(s):  
Retrospective Cohort ◽  
Lumbar Lordosis ◽  
Primary Outcome ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Single Level ◽  
Baseline Characteristics ◽  
Segmental Lordosis ◽  
Expandable Cages

Abstract BACKGROUND: One criticism of transforaminal lumbar interbody fusion (TLIF) is the inability to increase segmental lordosis (SL). Expandable interbody cages are a relatively new innovation theorized to allow improvement in SL. OBJECTIVE: To compare changes in SL and lumbar lordosis (LL) after TLIF with nonexpandable vs expandable cages. METHODS: We performed a retrospective cohort study of patients who were ≥18 years old and underwent single-level TLIF between 2011 and 2014. Patients were categorized by cage type (static vs expandable). Primary outcome of interest was change in SL and LL from preoperative values to those at 1 month and 1 year postoperatively. RESULTS: A total of 89 patients were studied (48 nonexpandable group, 41 expandable group). Groups had similar baseline characteristics. For SL, median (interquartile range) improvement was 3° for nonexpandable and 2° for expandable (unadjusted, P = .09; adjusted, P = .68) at 1 month postoperatively, and 3° for nonexpandable and 1° for expandable (unadjusted, P = .41; adjusted, P = .28) at 1 year postoperatively. For LL, median improvement was 1° for nonexpandable and 2° for expandable (unadjusted, P = .20; adjusted, P = .21), and 2° for nonexpandable and 5° for expandable (unadjusted, P = .15; adjusted, P = .51) at 1 year postoperatively. After excluding parallel expandable cages, there was still no difference in SL or LL improvement at 1 month or 1 year postoperatively between static and expandable cages (both unadjusted and adjusted, P &gt; .05). CONCLUSION: Patients undergoing single-level TLIF experienced similar improvements in SL and LL regardless of whether nonexpandable or expandable cages were placed.

scholarly journals Comparison of Simultaneous Single-position Oblique Lumbar Interbody Fusion and Percutaneous Pedicle Screw Fixation with Posterior Lumbar Interbody Fusion using O-arm Navigated C-arm free Technique for Lumbar Degenerative Diseases

2021 ◽  
Author(s):  
Ying Tan ◽  
Masato Tanaka ◽  
Sumeet Sonawane ◽  
Koji Uotani ◽  
Yoshiaki Oda ◽  
...  
Keyword(s):  
Blood Loss ◽  
Pedicle Screw ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Surgical Time ◽  
Intraoperative Radiation ◽  
Percutaneous Pedicle Screw ◽  
Indirect Decompression ◽  
Oblique Lumbar Interbody Fusion

Abstract Background: To compare the clinical, surgical and radiographic outcomes of O-arm navigated C-arm free, simultaneous single-position oblique lumbar interbody fusion (OLIF) and percutaneous pedicle screw (PPS) fixation with minimally invasive posterior/ transforaminal lumbar interbody fusion (MI-PLIF/TLIF).Methods: This is retrospective comparative study. The study included 98 patients, 63 in single position OLIF (group SO) and 35 in MI-PLIF/TLIF (group P/T). Surgical time, blood loss, mobilization time after surgery and complications were analyzed for all patients. Clinical evaluation included visual analog scale (VAS) for back pain, oswestry disability index (ODI). Radiological parameters included cage height (CH), cage to disc ratio (CDR), DH change, pre and postoperative disc height (DH), foraminal height (FH), foraminal area (FA), segmental lordosis (SL). Results: In group SO (vs group P/T), surgical time, blood loss and mobilization time were 117.7± 34.1 minutes (171.8 ± 40.6 minutes, p<0.000001), 139.2 ± 82.0 ml (vs. 374.2 ± 247.7 ml, p<0.000001) and 2.7 ±1 .0 days (vs 3.9 ± 2.4 days, p<0.000001) respectively. The CH, CDR, DH change and postoperative DH, FH, FA increase were statistically significant in group SO compared to group P/T. VAS and ODI improvement were similar in both groups. Mobilization time is shorter in group SO. Total complication rate in group SO was 7% while that in group P/T was 11%. Conclusions: Simultaneous single position O-arm navigated C-arm free OLIF reduces the surgical time, blood loss, mobilization time after operation without the risk of an adverse event of intraoperative radiation to operating staff. Good indirect decompression can be achieved with this method. Clinical results were similar in both groups.

Retrospective Review of Immediate Restoration of Lordosis in Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Comparison of Static and Expandable Interbody Cages

2019 ◽  
Vol 18 (5) ◽  
pp. 518-523 ◽  
Author(s):  
Avani S Vaishnav ◽  
Philip Saville ◽  
Steven McAnany ◽  
Sertac Kirnaz ◽  
Christoph Wipplinger ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Disc Height ◽  
Lumbar Interbody Fusion ◽  
Single Level ◽  
Expandable Cage ◽  
Sagittal Parameters ◽  
Segmental Lordosis ◽  
Expandable Cages

Abstract BACKGROUND Sagittal alignment is an important consideration in spine surgery. The literature is conflicted regarding the effect of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) on sagittal parameters and the role of expandable cage technology. OBJECTIVE To compare lordosis generated by static and expandable cages and to determine what factors affect postoperative sagittal parameters. METHODS Preoperative regional lordosis (RL), segmental lordosis (SL), and posterior disc height (PDH) were compared to postoperative values in single-level MI-TLIF performed using expandable or static cages. Patients were stratified based on preoperative SL: low lordosis (&lt;15 degrees), moderate lordosis (15-25 degrees), and high lordosis (&gt;25 degrees). Regression analyses were conducted to determine factors associated with postoperative SL and PDH. RESULTS Of the 171 patients included, 111 were in the static and 60 in the expandable cohorts. Patients with low preoperative lordosis experienced an increase in SL and maintained RL regardless of cage type. Those with moderate to high preoperative lordosis experienced a decrease in SL and RL with the static cage, but maintained SL and RL with the expandable cage. Although both cohorts showed an increase in PDH, the increase in the expandable cohort was greater. Preoperative SL was predictive of postoperative SL; preoperative SL, preoperative PDH, and cage type were predictive of postoperative PDH. CONCLUSION Expandable cages showed favorable results in restoring disc height and maintaining lordosis in the immediate postoperative period. Preoperative SL was the most significant predictor of postoperative SL. Thus, preoperative radiographic parameters and goals of surgery should be important considerations in surgical planning.

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