Neurologic deficit due to vertebral body osteophytes after oblique lumbar interbody fusion

Object The purpose of the present study was to evaluate the efficacy of anterior polymethylmethacrylate (PMMA) cement augmentation in instrumented anterior lumbar interbody fusion (ALIF) for patients with osteoporosis. Methods Sixty-two patients with osteoporosis who had undergone single-level instrumented ALIF for spondylolisthesis and were followed for more than 2 years were included in the study. The patients were divided into 2 groups: instrumented ALIF alone (Group I) and instrumented ALIF with anterior PMMA augmentation (Group II). Sixty-one patients were interviewed to evaluate the clinical results, and plain radiographs and 3D CT scans were obtained at the last follow-up in 46 patients. Results The mean degree of cage subsidence was significantly higher in Group I (19.6%) than in Group II (5.2%) (p = 0.001). The mean decrease of vertebral body height at the index level was also significantly higher in Group I (10.7%) than in Group II (3.9%) (p = 0.001). No significant intergroup differences were observed in the incidence of radiographic adjacent-segment degeneration (ASD) or in terms of pain and functional improvement. The incidences of clinical ASD (23% in Group I and 10% in Group II) were not significantly different. There was 1 case of nonunion and 3 cases of screw migration in Group I, but none resulted in implant failure. Conclusions Anterior PMMA augmentation during instrumented ALIF in patients with osteoporosis was useful to prevent cage subsidence and vertebral body collapse. In addition, PMMA augmentation did not increase the nonunion rate and incidence of ASD.

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P7. Effect of cage position and insertion angle in the oblique lumbar interbody fusion: A finite element study

The Spine Journal ◽

10.1016/j.spinee.2021.05.215 ◽

2021 ◽

Vol 21 (9) ◽

pp. S143

Author(s):

Jung-Woo Hur

Keyword(s):

Finite Element ◽

Interbody Fusion ◽

Lumbar Interbody Fusion ◽

Finite Element Study ◽

Insertion Angle ◽

Oblique Lumbar Interbody Fusion ◽

Element Study

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Posterior fixation can further improve the segmental alignment of lumbar degenerative spondylolisthesis with oblique lumbar interbody fusion

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04086-y ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jingye Wu ◽

Tenghui Ge ◽

Ning Zhang ◽

Jianing Li ◽

Wei Tian ◽

...

Keyword(s):

Interbody Fusion ◽

Degenerative Spondylolisthesis ◽

Reduction Ratio ◽

Posterior Fixation ◽

Lumbar Interbody Fusion ◽

Slip Ratio ◽

Radiographic Parameters ◽

Oblique Lumbar Interbody Fusion ◽

Lumbar Degenerative Spondylolisthesis ◽

Segmental Lordosis

Abstract Background For patients with degenerative spondylolisthesis, whether additional posterior fixation can further improve segmental alignment is unknown, compared with stand-alone cage insertion in oblique lumbar interbody fusion (OLIF) procedure. The aim of this study was to compare changes of the radiographical segmental alignment following stand-alone cage insertion and additional posterior fixation in the same procedure setting of OLIF for patients with degenerative spondylolisthesis. Methods A retrospective observational study. Selected consecutive patients with degenerative spondylolisthesis underwent OLIF procedure from July 2017 to August 2019. Five radiographic parameters of disc height (DH), DH-Anterior, DH-Posterior, slip ratio and segmental lordosis (SL) were measured on preoperative CT scans and intraoperative fluoroscopic images. Comparisons of those radiographic parameters prior to cage insertion, following cage insertion and following posterior fixation were performed. Results A total of thirty-three patients including six males and twenty-seven females, with an average age of 66.9 ± 8.7 years, were reviewed. Totally thirty-six slipped levels were assessed with thirty levels at L4/5, four at L3/4 and two at L2/3. Intraoperatively, with only anterior cage support, DH was increased from 8.2 ± 1.6 mm to 11.8 ± 1.7 mm (p < 0.001), DH-Anterior was increased from 9.6 ± 2.3 mm to 13.4 ± 2.1 mm (p < 0.001), DH-Posterior was increased from 6.1 ± 1.9 mm to 9.1 ± 2.1 mm (p < 0.001), the slip ratio was reduced from 11.1 ± 4.6% to 8.3 ± 4.4% (p = 0.020) with the slip reduction ratio 25.6 ± 32.3%, and SL was slightly changed from 8.7 ± 3.7° to 8.3 ± 3.0°(p = 1.000). Following posterior fixation, the DH was unchanged (from 11.8 ± 1.7 mm to 11.8 ± 2.3 mm, p = 1.000), DH-Anterior and DH-Posterior were slightly changed from 13.4 ± 2.1 mm and 9.1 ± 2.1 mm to 13.7 ± 2.3 mm and 8.4 ± 1.8 mm respectively (P = 0.861, P = 0.254), the slip ratio was reduced from 8.3 ± 4.4% to 2.1 ± 3.6% (p < 0.001) with the slip reduction ratio 57.9 ± 43.9%, and the SL was increased from 8.3 ± 3.0° to 10.7 ± 3.6° (p = 0.008). Conclusions Compared with stand-alone cage insertion, additional posterior fixation provides better segmental alignment improvement in terms of slip reduction and segmental lordosis in OLIF procedures in the treatment of lumbar degenerative spondylolisthesis.

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Efficacy and safety of oblique lumbar interbody fusion versus transforaminal lumbar interbody fusion for degenerative lumbar spondylolisthesis: A systematic review and meta-analysis

World Neurosurgery ◽

10.1016/j.wneu.2021.11.127 ◽

2021 ◽

Author(s):

Ai-Feng Liu ◽

Tian-Ci Guo ◽

Ji-Xin Chen ◽

Wei-Jie Yu ◽

Hui-Chuan Feng ◽

...

Keyword(s):

Systematic Review ◽

Interbody Fusion ◽

Meta Analysis ◽

Transforaminal Lumbar Interbody Fusion ◽

Lumbar Interbody Fusion ◽

Efficacy And Safety ◽

Degenerative Lumbar Spondylolisthesis ◽

Oblique Lumbar Interbody Fusion ◽

Lumbar Spondylolisthesis

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Introducing V-line as a New Strategy to Choose Surgical Corridor in Oblique Lumbar Interbody Fusion at the L5-S1 Segment

10.21203/rs.3.rs-118245/v1 ◽

2020 ◽

Author(s):

Wei Zhang ◽

Xing Du ◽

Yong Zhu ◽

Wei Luo ◽

Ben Wang ◽

...

Keyword(s):

Injury Risk ◽

Protective Factor ◽

Interbody Fusion ◽

Iliac Crest ◽

Iliac Vein ◽

Lumbar Interbody Fusion ◽

Oblique Lumbar Interbody Fusion ◽

Multiple Variables ◽

Surgical Corridor ◽

Psoas Major

Abstract Purpose: To assess the availability of oblique lumbar interbody fusion at the level of L5-S1 (OLIF51) and to choose ideal surgical corridor in OLIF51 by introducing V-line. Methods: The axial views through the center of L5-S1 disc were reviewed. We adopt 18mm as the width of the simulated surgical corridor. The midline of the surgical corridor is at the center of L5-S1 disc. According to the traction distance of the left iliac vein (LCIV) and psoas major (PM), we defined all the subjects as V (+) (traction-difficultly LCIV), V (-) (traction-friendly LCIV), P (+) (traction-difficultly PM) and P (-) (traction-friendly PM). V-line was defined as a straight line dividing equally the simulated surgical corridor. All cases were divided into 2 groups: The V-line (+) group, more than half of the LCIV region is located in ventral part of V-line; the V-line (-) group, more than half of the LCIV region is located in dorsal part of V-line. Multiple variables regressive analysis was conducted to analyze the independent risk factors of V-line (+). Results: V-line (+) was found in 36 (38.7%) patients and V-line (-) in 57 (61.3%). Incidence of V (+) and P (+) were 35.4% (33/93) and 30.1% (28/93), respectively. 16.1% (15/93) subjects processed V (+) and P (+) at the same time. The independent risk factor of V-line (+) were gender of male (P = 0.034, OR: 12.152) and medial position of LCIV (P ＜ 0.001, OR: 265.085). High iliac crest was a significant independent protective factor (P = 0.001, OR: 0.750). Conclusions: Most patients were suitable for OLIF51. V-line could assess the injury risk of LCIV. Among male patients having the LCIV near the midline or the iliac crest relatively low, a surgical corridor external to the LCIV should be taken into consideration.

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