scholarly journals Radiographic and Clinical Outcomes following Combined Oblique Lumbar Interbody Fusion and Lateral Instrumentation for the Treatment of Degenerative Spine Deformity: A Preliminary Retrospective Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Kai Wang ◽  
Can Zhang ◽  
Cheng Cheng ◽  
Fengzeng Jian ◽  
Hao Wu
Keyword(s):  
Back Pain ◽  
Cobb Angle ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Operation Time ◽  
Spine Deformity ◽  
Lumbar Interbody Fusion ◽  
Degenerative Spine ◽  
Oblique Lumbar Interbody Fusion

Objective. The authors recently used a combination of minimally invasive oblique lumbar interbody fusion (OLIF) and lateral fixation for the treatment of degenerative spine deformity. The early results were promising. Radiographic and clinical results as well as complications were retrospectively assessed in the current study. Methods. Eleven patients with degenerative spine deformity underwent combined OLIF and lateral instrumentation without real-time electromyography (EMG) monitoring. Radiographic measurements including coronal Cobb angle, central sacral vertebral line (CSVL), lumbar lordosis (LL), sagittal vertebral axis (SVA), pelvic tilt (PT), and LL-PI (pelvic incidence) mismatch were taken preoperatively and at last follow-up postoperatively in all patients. Concurrently, the visual analog score (VAS) for back pain and the Oswestry Disability Index (ODI) score were used to assess clinical outcomes. The fusion rate of OLIF cage, total blood loss, operation time, hospital stay, and complications were also evaluated. Results. At last follow-up, all patients who underwent combined OLIF and lateral instrumentation achieved statistically significant improvement in coronal Cobb angle (from 15.3±4.7° to 5.9±3.1°, p < 0.01), LL (from 34.3±9.0° to 48.2±8.5°, p < 0.01), PT (from 24.2±9.6° to 16.2±6.0°, p < 0.01), LL-PI mismatch (from 15.4±8.7° to 7.0±3.7°, p < 0.01), CSVL (from 2.1±2.2cm to 0.7±0.9cm, p = 0.01), and SVA (from 7.0±3.9cm to 2.9±1.8cm, p < 0.01). VAS for back pain (from 6.9±1.4 to 2.0±0.9, p < 0.05) and ODI (from 39.5±3.1 to 21.9±3.6, p < 0.01) improved significantly after surgery. Conclusions. A combination of OLIF and lateral instrumentation is an effective and safety means of achieving correction of both coronal and sagittal deformity, resulting in improvement of quality of life in patients with degenerative spine deformity. It is a promising way to treat patients with moderate degenerative spine deformity.

scholarly journals Clinical Outcomes of Biportal Endoscopic Interlaminar Decompression with Oblique Lumbar Interbody Fusion (OLIF): Comparative Analysis with TLIF

2021 ◽  
Vol 11 (5) ◽  
pp. 630
Author(s):  
Ho-Jin Lee ◽  
Eugene J. Park ◽  
Jae-Sung Ahn ◽  
Sang Bum Kim ◽  
Youk-Sang Kwon ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Invasive Procedure ◽  
Foraminal Stenosis ◽  
Lumbar Interbody Fusion ◽  
Combination Technique ◽  
Estimated Blood Loss ◽  
Group A ◽  
Oblique Lumbar Interbody Fusion

Oblique lumbar interbody fusion (OLIF) improves the spinal canal, with favorable clinical outcomes. However, it may not be useful for treating concurrent, severe central canal stenosis (SCCS). Therefore, we added biportal endoscopic spinal surgery (BESS) after OLIF, evaluated the combined procedure for one-segment fusion with clinical outcomes, and compared it to open conventional TLIF. Patients were divided into two groups: Group A underwent BESS with OLIF, and Group B were treated via TLIF. The length of hospital stay (LOS), follow-up period, operative time, estimated blood loss (EBL), fusion segment, complications, and clinical outcomes were evaluated. Clinical outcomes were measured using Visual Analog Scale (VAS) scores, Oswestry Disability Index (ODI) scores, and the modified Macnab criteria. All the clinical parameters improved significantly after the operation in Group A. The only significant between-group difference was that the EBL was significantly lower in Group A. At the final follow-up, no clinical parameter differed significantly between the groups. No complications developed in either group. We suggest that our combination technique is a useful, alternative, minimally invasive procedure for the treatment of one-segment lumbar SCCS associated with foraminal stenosis or segmental instability.

scholarly journals The effect of two surgical approach Lordosis correction in degenerative lumbar diseases: minimally invasive oblique lumbar interbody fusion (OLIF) versus transforminal lumbar interbody fusion (TLIF)

2020 ◽  
Author(s):  
Renjie Li ◽  
Xiaofeng Shao ◽  
Weimin Jiang
Keyword(s):  
Hospital Stay ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Operation Time ◽  
Bed Rest ◽  
Leg Pain ◽  
Lumbar Interbody Fusion ◽  
Significant Difference ◽  
Vas Scores ◽  
Oblique Lumbar Interbody Fusion

Abstract Background: The present study aimed to compare clinical outcomes and radiographic results of oblique lumbar interbody fusion (OLIF) with transforaminal lumbar interbody fusion (TLIF) in patients with lumbar spondylolisthesis.Methods: We retrospectively reviewed and compared 28 patients who underwent OLIF (OLIF group) and 35 who underwent TLIF (TLIF group). The operation time, intraoperative hemorrhage, bed rest duration, and length of hospital stay were compared between the 2 groups. Clinical results were evaluated with the ODI and VAS for back and leg pain. Radiological results were evaluated with disc height (DH), foraminal height (FH), fused segment lordosis (FSL) and lumbar lordosis (LL).Results: The OLIF group had less intraoperative blood loss, shorter operative time, bed rest time, and hospital stay than TLIF group (P<0.05). The OLIF group had lower VAS scores for back pain and lower VAS scores for leg pain after surgery compared with before surgery (P<0.05), The OLIF group had lower ODI after surgery compared with before surgery (P<0.05). The was no significant difference in decrease value in VAS and ODI after surgery between the two groups (P>0.05). No significant differences were found in DH, FH and LL between the 2 groups preoperatively (P>0.05). The OLIF group showed higher DH and FH than the TLIF group at all time points (P<0.05). No significant differences were found in FSH between the 2 groups at any time point.Conclusions: OLIF has similar good long-term clinical outcomes of TLIF with the additional benefits of less initial postoperative pain, early rehabilitation, shorter hospitalization, and fewer complications.

scholarly journals Comparison of Clinical Outcomes Between Stand-Alone Oblique Lumber Interbody Fusion and Posterior Lumbar Interbody Fusion for Treatment of Degenerative Lumbar Diseases

2020 ◽  
Author(s):  
Run Peng Guo ◽  
Xian Da Gao ◽  
Pei Yu Du ◽  
Wen Yuan Ding ◽  
Lei Ma
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Operation Time ◽  
Lumbar Interbody Fusion ◽  
Incision Length ◽  
Degenerative Lumbar Diseases

Abstract Background: This study evaluated the clinical and imaging results of oblique lumber interbody fusion (OLIF) and posterior lumbar interbody fusion (PLIF) in the treatment of degenerative lumbar diseases.Methods: The clinical data of 99 patients with degenerative lumbar diseases in the Third Hospital of Hebei Medical University from January 2016 to January 2018 were analyzed retrospectively. 49 cases were dealt with by OLIF (stand-alone) (OLIF group) and 50 cases with PLIF (PLIF group). Clinical and imaging data were collected before surgery and at each follow-up visit. Clinical data included operation time, blood loss, incision length, length of hospital stay, visual analogue score (VAS), Oswestry dysfunction index (ODI), Japanese orthopaedic association (JOA) scores and complications. imaging measurment included the height of segmental intervertebral space, lumbar lordotic angle, operative segmental lordotic angle and fusion rate. The relationship between clinical results and radiology was assessed by comparing the radiological results before and after operation.Results: 99 cases of interbody fusion were performed successfully, and all patients had clinical improvement. The follow-up time was 24-38 months. The operation time, intraoperative blood loss, incision length and hospital stay in OLIF group were significantly less than those in the PLIF group (p<0.05). The intervertebral disc height, lumbar lordotic angle and operative segmental lordotic angle in the two groups were significantly enhanced compared with those before operation, and the difference was statistically significant (p<0.05). All of them achieved satisfactory fusion effect. Complications were found in 5 cases in OLIF group and 13 cases in PLIF group.Conclusion: Both OLIF and PLIF are effective in the treatment of degenerative lumbar diseases. Compared with PLIF, OLIF has a lot advantages in early stage after operation, However, similar clinical outcomes were achieved in the two approaches at mid-term follow-up visit.

Comparison between oblique lumbar interbody fusion and posterior lumbar interbody fusion in the treatment of degenerative lumbar scoliosis: a retrospective clinical study

2020 ◽  
Author(s):  
chaojun Xu ◽  
Yingjie HAO ◽  
Lei YU ◽  
Guangduo ZHU ◽  
Zhinan REN ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Length Of Hospital Stay ◽  
Vertical Axis ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Interbody Fusion ◽  
Lumbar Scoliosis ◽  
Significant Difference ◽  
Oblique Lumbar Interbody Fusion

Abstract Backgroud Few studies compared radiographic and clinical outcomes between oblique lumbar interbody fusion and posterior lumbar interbody fusion in degenerative lumbar scoliosis. Methods This study retrospectively analyzed the case data of 40 patients with degenerative lumbar scoliosis in our hospital from July 2016 to October 2018. Among which,19 cases underwent oblique lumbar Interbody fusion(OLIF group) and 21 cases underwent posterior lumbar interbody fusion(PLIF group). The duration of the operation, volume of intraoperative hemorrhage, incision length, bed rest time, length of hospital stay, and complications were recorded for all patients. The clinical effects of 40 patients were evaluated by VAS for back pain and Oswestry Disability Index (ODI) and The radiographic parameters were evaluated using the lumbar scoliosis Cobb angle, sagittal vertical axis(SVA), coronal vertical axis(CVA), lumbar lordosis(LL), pelvic tilt(PT), sacral slope(SS), and Disc height(DH). Results The duration of the operation, the volume of intraoperative hemorrhage, incision length, bed rest time, length of hospital stay of the OLIF group were shorter than the PLIF group( P ＜ 0.05 ). The VAS scores for back pain, the ODI of the two groups were significantly decreased, which compared with the preoperative( P ＜ 0.05 )，which in OLIF group was significantly more decreased than in PLIF( P ＜ 0.05 ) at 7 days and 3 months postoperatively, but at the last follow-up there were no significant difference between the two groups( P ＞ 0.05 ); The lumbar scoliosis Cobb angle, SVA, CVA, PT, LL, SS were significantly improved postoperatively( P ＜ 0.05 ). The OLIF group showed higher DH, smaller Cobb angle, and greater LL than the PLIF group at any time point( P ＜ 0.05 ). but there were no significant difference in SVA, CVA, PT and SS between the two groups at any follow-up points( P ＞ 0.05 ). The overall complication rate was slightly higher in the PLIF group（47.62%）than in the OLIF group（26.32%）without significant difference(x 2 =1.931, P =0.165). But the incidence of major complications in the PLIF group was significantly higher than that in the OLIF group (Fisher, P =0.026). Conclusion OLIF provides an alternative minimally invasive treatment for DLS, which compared with PLIF. It has the characteristics of a small incision, rapid recovery, fewer complications related to the surgical approach, and satisfactory orthopedics. Keywords : Minimally invasive, Oblique lumbar interbody fusion, Degenerative adult lumbar scoliosis , Posterior lumbar interbody fusion

Surgical treatment of adult degenerative spondylolisthesis by instrumented transforaminal lumbar interbody fusion in the Han nationality

2009 ◽  
Vol 10 (5) ◽  
pp. 496-499 ◽  
Author(s):  
Hao Xu ◽  
Hao Tang ◽  
Zhonghai Li
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Low Back ◽  
Lumbar Interbody Fusion ◽  
Peek Cage ◽  
Han Nationality

Object The transforaminal lumbar interbody fusion (TLIF) procedure was developed to provide the surgeon with a fusion procedure that may reduce many of the risks and limitations associated with posterior lumbar interbody fusion, yet produce similar stability in the spine. There are few large series with long-term follow-up data regarding instrumented TLIF and placement of 1 diagonal polyetheretherketone (PEEK) cage. The authors performed a prospective study to evaluate the outcome and safety of instrumented TLIF with 1 diagonal PEEK cage for degenerative spondylolisthesis in the Han nationality in China. Methods Between May 2001 and April 2006, 60 patients (35 men and 25 women; mean age 55.5 years, range 45–70 years) with symptomatic degenerative spondylolisthesis underwent the TLIF procedure with 1 diagonal PEEK cage and additional pedicle screw internal fixation at the authors' institution. The inclusion criteria involved degenerative spondylolisthesis (Grades I and II) in patients with chronic low-back pain with or without leg pain. Results One patient had a postoperative temporary motor and sensory deficit of the adjacent nerve root. Reoperation was required in 1 patient because of pedicle screw migration. One patient developed a pseudarthrosis and had increasing complaints of low-back pain 1 year postoperatively and underwent a subsequent revision surgery. Two patients had nerve root symptomatic compression resulting from cage migration and insufficient decompression after surgery, and they underwent revision. Two patients had a dural tear that required fibrin glue application during surgery. No implant fracture or subsidence occurred in any patient. Clinically, the pain index and Oswestry Disability Index (ODI) score improved significantly from before surgery to the 2-year follow-up. In the TLIF group, the pain index improved from 69 to 25 (p < 0.001). The postoperative ODI showed a significant postoperative reduction of disability during the whole period of follow-up (p < 0.001). The preoperative mean ODI score was 32.3 (16–80), and postoperative 13.1 (0–28). Disc space height and foraminal height were restored by the surgery and maintained at the latest follow-up time. Conclusions In the authors' experience, instrumented TLIF with 1 diagonal PEEK cage can be a surgical option for treatment of degenerative spondylolisthesis in the Han nationality in China.

Unilateral transforaminal lumbar interbody fusion and bilateral anterior-column fixation with two Brantigan I/F cages per level: clinical outcomes during a minimum 2-year follow-up period

2006 ◽  
Vol 4 (3) ◽  
pp. 198-205 ◽  
Author(s):  
Hiroshi Taneichi ◽  
Kota Suda ◽  
Tomomichi Kajino ◽  
Akira Matsumura ◽  
Hiroshi Moridaira ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Japanese Orthopaedic Association ◽  
Posterior Lumbar Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Anterior Column ◽  
Lumbar Interbody Fusion ◽  
Anterior Column Support ◽  
The Mean

Object There are no published reports of unilateral transforaminal lumbar interbody fusion (TLIF) in which two Brantigan I/F cages were placed per level through a single portal to achieve bilateral anterior-column support. The authors describe such a surgical technique and evaluate the clinical outcomes of this procedure. Methods Data obtained in 86 (93.5%) of the first 92 consecutive patients who underwent the procedure were retrospectively reviewed; the minimum follow-up duration was 2 years. The clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) scoring system. Disc height, disc angle, cage positioning in the axial plane, and fusion status were radiographically evaluated. The mean follow-up period was 33.8 months. The mean improvement in the JOA score was 77.2%. Fusion was successful in 93% of the cases. According to the Farfan method, the mean anterior and posterior disc heights increased from 20.2 and 16.9% preoperatively to 35.9 and 22.7% at follow up, respectively (p < 0.01). The mean disc angle increased from 4.8° preoperatively to 7.5° at last follow-up examination (p < 0.01). Two cages were correctly placed to achieve bilateral anterior-column support in greater than 85% of the cases. The following complications occurred: hardware migration in two patients and deep infection cured by intravenous antibiotic therapy in one patient. Conclusions Unilateral TLIF involving the placement of two Brantigan cages per level led to good clinical results. Two Brantigan cages were adequately placed via a single portal, and reliable bilateral anterior-column support was achieved. Although the less invasive unilateral approach was used, the outcomes were as good as those in many reported series of posterior lumbar interbody fusion in which the Brantigan cages were placed via the bilateral approach.

scholarly journals Efficacy and radiographic analysis of oblique lumbar interbody fusion in treating adult spinal deformity

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257316
Author(s):  
Dae-Jean Jo ◽  
Eun-Min Seo
Keyword(s):  
Spinal Deformity ◽  
Interbody Fusion ◽  
Adult Spinal Deformity ◽  
Deformity Correction ◽  
Lumbar Interbody Fusion ◽  
Spinal Fixation ◽  
Invasive Approach ◽  
Radiographic Parameters ◽  
Oblique Lumbar Interbody Fusion

Adult spinal deformity (ASD) is usually rigid and requires a combined anterior–posterior approach for deformity correction. Anterior lumbar interbody fusion (ALIF) allows direct access to the disc space and placement of a large interbody graft. A larger interbody graft facilitates correction of ASD. However, an anterior approach carries significant risks. Lateral lumbar interbody fusion (LLIF) through a minimally invasive approach has recently been used for ASD. The present study was performed to evaluate the effectiveness of oblique lumbar interbody fusion (OLIF) in the treatment of ASD. We performed a retrospective study utilizing the data of 74 patients with ASD. The inclusion criteria were lumbar coronal Cobb angle > 20°, pelvic incidence (PI)–lumbar lordosis (LL) mismatch > 10°, and minimum follow–up of 2 years. Patients were divided into two groups: ALIF combined with posterior spinal fixation (ALIF+PSF) (n = 38) and OLIF combined with posterior spinal fixation (OLIF+PSF) (n = 36). The perioperative spinal deformity radiographic parameters, complications, and health-related quality of life (HRQoL) outcomes were assessed and compared between the two groups. The preoperative sagittal vertical axis (SVA), LL, PI–LL mismatch, and lumbar Cobb angles were similar between the two groups. Patients in the OLIF+PSF group had a slightly higher mean number of interbody fusion levels than those in the ALIF+PSF group. At the final follow–up, all radiographic parameters and HRQoL scores were similar between the two groups. However, the rates of perioperative complications were higher in the ALIF+PSF than OLIF+PSF group. The ALIF+PSF and OLIF+PSF groups showed similar radiographic and HRQoL outcomes. These observations suggest that OLIF is a safe and reliable surgical treatment option for ASD.

scholarly journals Efficacy and radiographic analysis of oblique lumbar interbody fusion for degenerative lumbar spondylolisthesis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Menghui Wu ◽  
Jia Li ◽  
Mengxin Zhang ◽  
Xufeng Ding ◽  
Dongxu Qi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Interbody Fusion ◽  
Radiographic Analysis ◽  
Lumbar Interbody Fusion ◽  
Intraoperative Blood Loss ◽  
Significant Difference ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Oblique Lumbar Interbody Fusion ◽  
Lumbar Spondylolisthesis

Abstract Background To compare the clinical efficacy and radiographic analysis of oblique lumbar interbody fusion (OLIF) and traditional posterior lumbar interbody fusion (PLIF) in treating degenerative lumbar spondylolisthesis (DLS). Methods Grade I DLS patients admitted to the Third Hospital of Hebei Medical University were retrospectively reviewed. In sum, 78 patients that underwent OLIF (n = 31) and PLIF (n = 47) treatment of DLS were recruited. Clinical data including clinical and radiological evaluations were collected pre-operatively and at each follow-up. Japanese Orthopaedic Association (JOA) scores, Oswestry Disability Index (ODI), lumbar lordosis (LL), disc height (DH), and fusion rates were compared between the OLIF and PLIF groups. Results The operation time for both groups was 131.3 ± 14.6 min in the OLIF group and 156.9 ± 37.4 min in the PLIF group (P < 0.001). The intraoperative blood loss was 163.6 ± 63.9 ml in the OLIF group and 496.8 ± 122.6 ml in the PLIF group (P < 0.001). The length of the surgical incision was 4.63 ± 0.57 cm in the OLIF group and 11.83 ± 1.37 cm in the PLIF group (P < 0.001). The number of intraoperative and post-operative complications for both groups was 10 in the OLIF group and 20 in the PLIF group. Significant clinical improvement (P < 0.05) was observed in JOA scores and ODI when comparing pre-operative evaluation and final follow-up. After statistical analysis, there was no significant difference in the preoperative JOA scores between the two groups. There was no significant difference when comparing pre-operative LL and DH for either group. Post-operative reexamination was improved as compared to pre-operative exams. And the improvement of DH was better in the OLIF group as compared to the PLIF group. Conclusions For DLS patients, both OLIF and PLIF can achieve good results. Furthermore, OLIF displays marked advantages including smaller surgical incisions, shorter anesthesia times, decreased intraoperative blood loss, and post-operative pain better relieved.

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