Radiographic and clinical evaluation of single-level lateral interbody fusion in patients with severe stenosis analyzed using cluster analysis

The purpose of this paper was to investigate the stand-alone lateral interbody fusion as a minimally invasive option for the treatment of low-grade degenerative spondylolisthesis with a minimum 24-month followup. Prospective nonrandomized observational single-center study. 52 consecutive patients (67.6±10 y/o; 73.1% female;27.4±3.4 BMI) with single-level grade I/II single-level degenerative spondylolisthesis without significant spine instability were included. Fusion procedures were performed as retroperitoneal lateral transpsoas interbody fusions without screw supplementation. The procedures were performed in average 73.2 minutes and with less than 50cc blood loss. VAS and Oswestry scores showed lasting improvements in clinical outcomes (60% and 54.5% change, resp.). The vertebral slippage was reduced in 90.4% of cases from mean values of 15.1% preoperatively to 7.4% at 6-week followup (P<0.001) and was maintained through 24 months (7.1%,P<0.001). Segmental lordosis (P<0.001) and disc height (P<0.001) were improved in postop evaluations. Cage subsidence occurred in 9/52 cases (17%) and 7/52 cases (13%) spine levels needed revision surgery. At the 24-month evaluation, solid fusion was observed in 86.5% of the levels treated. The minimally invasive lateral approach has been shown to be a safe and reproducible technique to treat low-grade degenerative spondylolisthesis.

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Clinical evaluation of microendoscopy-assisted extreme lateral interbody fusion

Journal of Spine Surgery ◽

10.21037/jss.2017.08.09 ◽

2017 ◽

Vol 3 (3) ◽

pp. 398-402 ◽

Cited By ~ 2

Author(s):

Tomohide Segawa ◽

Hirohiko Inanami ◽

Hisashi Koga

Keyword(s):

Clinical Evaluation ◽

Interbody Fusion ◽

Lateral Interbody Fusion ◽

Extreme Lateral Interbody Fusion ◽

Lateral Interbody

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Comparison of clinical outcomes achieved with oblique lateral interbody fusion with or without supplementary instrumentation in patients with single-level lumbar degenerative disease

10.21203/rs.3.rs-227251/v1 ◽

2021 ◽

Author(s):

Zhao Lang ◽

Yuqing Sun ◽

Qiang Yuan ◽

Jingye Wu ◽

Mingxing Fan ◽

...

Keyword(s):

Clinical Outcomes ◽

Interbody Fusion ◽

Degenerative Disease ◽

Mineral Density ◽

Lumbar Degenerative Disease ◽

Single Level ◽

Lateral Interbody Fusion ◽

Estimated Blood Loss ◽

Oblique Lateral Interbody Fusion ◽

Lateral Interbody

Abstract Background Oblique lateral interbody fusion (OLIF) is applied often to treat degenerative disc disease in the lumbar spine. Stand-alone OLIF prevents morbidities associated with supplemental fixation and is less expensive. However, it remains controversial whether stand-alone OLIF is sufficient to avoid subsidence for single-level diseases. Additionally, bilateral pedicle screw (BPS) and bilateral transfacet screw (BTS) fixation are well-established posterior fixation methods that can offer improved biomechanical stability. But the comparison of clinical outcomes of OLIF with and without supplementary instrumentation is lack. Methods We retrospectively examined 20 patients who underwent single-level stand-alone OLIF for symptomatic lumbar degenerative disease at L1–L5 (SA group). Groups of patients treated with OLIF plus BPS (n = 20, BPS group) or BTS (n = 20, BTS group) were matched for age, sex, diagnosis, operative level, body mass index, and bone mineral density. The disk height index (DHI), segmental lordotic (SL) angle, and lumbar lordotic (LL) angle were measured preoperatively and at 3 days and 6 months postoperatively. Clinical outcomes were evaluated. Results Significant disc height loss was observed in all groups, but was greater in the SA and BTS groups than in the BPS group at the 6-month follow-up. The SL and LL angles were not affected in any group. The operative time was significantly less in the SA group, and the estimated blood loss was significantly higher in the BPS group. At 6 months post-surgery, improvements in clinical outcomes were evident in all groups, but the VAS (back pain), JOA, and ODI scores were worse in the SA group than in the other groups. Conclusions Stand-alone OLIF was associated with greater subsidence and poorer clinical outcomes compared with OLIF plus supplementary instrumentation. The addition of BTS did not decrease the degree of subsidence, but provided clinical outcomes comparable to those achieved with BPS.

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Comparison of clinical outcomes achieved with oblique lateral interbody fusion with or without supplementary instrumentation in patients with single-level lumbar degenerative disease

10.21203/rs.3.rs-227251/v2 ◽

2021 ◽

Author(s):

Zhao Lang ◽

Yuqing Sun ◽

Qiang Yuan ◽

Jingye Wu ◽

Mingxing Fan ◽

...

Keyword(s):

Clinical Outcomes ◽

Interbody Fusion ◽

Degenerative Disease ◽

Mineral Density ◽

Lumbar Degenerative Disease ◽

Single Level ◽

Lateral Interbody Fusion ◽

Estimated Blood Loss ◽

Oblique Lateral Interbody Fusion ◽

Lateral Interbody

Abstract Background Oblique lateral interbody fusion (OLIF) is applied often to treat degenerative disc disease in the lumbar spine. Stand-alone OLIF prevents morbidities associated with supplemental fixation and is less expensive. However, it remains controversial whether stand-alone OLIF is sufficient to avoid subsidence for single-level diseases. Additionally, bilateral pedicle screw (BPS) and bilateral transfacet screw (BTS) fixation are well-established posterior fixation methods that can offer improved biomechanical stability. But the comparison of clinical outcomes of OLIF with and without supplementary instrumentation is lack. Methods We retrospectively examined 20 patients who underwent single-level stand-alone OLIF for symptomatic lumbar degenerative disease at L1–L5 (SA group). Groups of patients treated with OLIF plus BPS (n = 20, BPS group) or BTS (n = 20, BTS group) were matched for age, sex, diagnosis, operative level, body mass index, and bone mineral density. The disk height index (DHI), segmental lordotic (SL) angle, and lumbar lordotic (LL) angle were measured preoperatively and at 3 days and 6 months postoperatively. Clinical outcomes were evaluated. Results Significant disc height loss was observed in all groups, but was greater in the SA and BTS groups than in the BPS group at the 6-month follow-up. The SL and LL angles were not affected in any group. The operative time was significantly less in the SA group, and the estimated blood loss was significantly higher in the BPS group. At 6 months post-surgery, improvements in clinical outcomes were evident in all groups, but the VAS (back pain), JOA, and ODI scores were worse in the SA group than in the other groups. Conclusions Stand-alone OLIF was associated with greater subsidence and poorer clinical outcomes compared with OLIF plus supplementary instrumentation. The addition of BTS did not decrease the degree of subsidence, but provided clinical outcomes comparable to those achieved with BPS.

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Radiographical and Clinical Evaluation of Extreme Lateral Interbody Fusion

Spine ◽

10.1097/brs.0000000000000645 ◽

2014 ◽

Vol 39 (26) ◽

pp. E1582-E1591 ◽

Cited By ~ 33

Author(s):

Antoine G. Tohmeh ◽

Derek Khorsand ◽

Blake Watson ◽

Xavier Zielinski

Keyword(s):

Clinical Evaluation ◽

Interbody Fusion ◽

Lateral Interbody Fusion ◽

Extreme Lateral Interbody Fusion ◽

Lateral Interbody

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Treatment of one-level degenerative lumbar spondylolisthesis with severe stenosis by oblique lateral interbody fusion: clinical and radiological results after a minimal 1-year follow-up

Interdisciplinary Neurosurgery ◽

10.1016/j.inat.2021.101321 ◽

2021 ◽

pp. 101321

Author(s):

Emeric Lefèvre ◽

Henri d'Astorg ◽

Vincent Fière ◽

Rémi Gauthé ◽

Thais Dutra Vieira ◽

...

Keyword(s):

Interbody Fusion ◽

Severe Stenosis ◽

Lateral Interbody Fusion ◽

Radiological Results ◽

Degenerative Lumbar Spondylolisthesis ◽

Lumbar Spondylolisthesis ◽

Clinical And Radiological Results ◽

Oblique Lateral Interbody Fusion ◽

Lateral Interbody

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Clinical Evaluation of Microendoscopy-Assisted Oblique Lateral Interbody Fusion

Medicina ◽

10.3390/medicina57020135 ◽

2021 ◽

Vol 57 (2) ◽

pp. 135

Author(s):

Tomohide Segawa ◽

Hisashi Koga ◽

Masahito Oshina ◽

Katsuhiko Ishibashi ◽

Yuichi Takano ◽

...

Keyword(s):

Interbody Fusion ◽

Outcome Measure ◽

Operation Time ◽

Secondary Outcome ◽

Invasive Technique ◽

Lateral Interbody Fusion ◽

Surgical Methods ◽

Significant Difference ◽

Oblique Lateral Interbody Fusion ◽

Lateral Interbody

Background and objectives: Oblique Lateral Interbody Fusion (OLIF) is a widely performed, minimally invasive technique to achieve lumbar lateral interbody fusion. However, some complications can arise due to constraints posed by the limited surgical space and visual field. The purpose of this study was to assess the short-term postoperative clinical outcomes of microendoscopy-assisted OLIF (ME-OLIF) compared to conventional OLIF. Materials and Methods: We retrospectively investigated 75 consecutive patients who underwent OLIF or ME-OLIF. The age, sex, diagnosis, and number of fused levels were obtained from medical records. Operation time, estimated blood loss (EBL), and intraoperative complications were also collected. Operation time and EBL were only measured per level required for the lateral procedure, excluding the posterior fixation surgery. The primary outcome measure was assessed using the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). The secondary outcome measure was assessed using the Oswestry Disability Index (ODI) and the European Quality of Life–5 Dimensions (EQ-5D), measured preoperatively and 1-year postoperatively. Results: This case series consisted of 14 patients in the OLIF group and 61 patients in the ME-OLIF group. There was no significant difference between the two groups in terms of the mean operative time and EBL (p = 0.90 and p = 0.50, respectively). The perioperative complication rate was 21.4% in the OLIF group and 21.3% in the ME-OLIF group (p = 0.99). In both groups, the postoperative JOABPEQ, EQ-5D, and ODI scores improved significantly (p < 0.001). Conclusions: Although there was no significant difference in clinical results between the two surgical methods, the results suggest that both are safe surgical methods and that microendoscopy-assisted OLIF could serve as a potential alternative to the conventional OLIF procedure.

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