scholarly journals The Impact of Vertebral End Plate Lesions on the Radiological Outcome in Oblique Lateral Interbody Fusion

2020 ◽  
pp. 219256822094144
Author(s):  
Nam-Su Chung ◽  
Han-Dong Lee ◽  
Chang-Hoon Jeon
Keyword(s):  
Interbody Fusion ◽  
Modic Changes ◽  
Radiological Outcome ◽  
End Plate ◽  
Radiological Parameters ◽  
Cage Subsidence ◽  
The Mean ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Study Design: Retrospective case-control study. Objectives: Vertebral end plate (EP) lesions include Modic changes, Schmorl’s nodes, EP erosion, EP sclerosis, and so on. While previous studies have mostly focused on the association between vertebral EP lesions and low back pain, few studies evaluated the influence of vertebral EP lesions on the radiological outcomes in lumbar interbody fusion. Methods: This study included a total of 125 operated disc levels from 86 consecutive patients who underwent a 1- or 2-level oblique lateral interbody fusion (OLIF) and had more than 1-year regular follow-up. The presence of vertebral EP lesions, changes in disc heights/angle, cage subsidence, and fusion grade were examined. The associations between vertebral EP lesions and radiological parameters were analyzed. Result: The presence of Modic changes, Schmorl’s node, EP cartilage erosion, and EP sclerosis were found in 72 (57.6%), 26 (20.8%), 31 (24.8%), and 44 (35.2%) disc levels, respectively. The mean anterior disc height increased from 6.9 ± 3.8 mm to 13.1 ± 2.7 mm ( P < .001) and the mean segmental angle increased from 2.9° ± 5.8° to 9.2° ± 4.8° ( P < .001) at the last follow-up. The overall fusion rate was 98.4% (123/125) and cage subsidence rate was 7.2% (9/125). All radiological parameters and cage subsidence rate were not different regardless of vertebral EP lesions. Conclusions: Vertebral EP lesions did not affect the overall radiological outcome in 1- or 2-level OLIF. These results come from the stable contact between lateral cage and peripheral rim of vertebral EP.

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

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Yachong Huo ◽  
Dalong Yang ◽  
Lei Ma ◽  
Haidong Wang ◽  
Wenyuan Ding ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Disc Height ◽  
Degenerative Lumbar Spondylolisthesis ◽  
The Mean ◽  
One Year ◽  
Psoas Major ◽  
Lumbar Spondylolisthesis ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

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.

scholarly journals The clinical and radiographic outcomes of stand-alone Oblique Lateral Interbody Fusion in Treatment of Adult Degenerative Scoliosis

2019 ◽  
Author(s):  
Chen Liu ◽  
Xin Ge ◽  
Yu Zhang ◽  
Liang Xiao ◽  
Hongguang Xu
Keyword(s):  
Cobb Angle ◽  
Lumbar Lordosis ◽  
Interbody Fusion ◽  
Degenerative Scoliosis ◽  
Adult Degenerative Scoliosis ◽  
Radiographic Outcomes ◽  
The Mean ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Abstract Background The minimally invasive treatment for adult degenerative scoliosis has become more and more popular. The purpose of this study was to evaluate the efficiency of stand-alone oblique lateral interbody fusion for the treatment of adult degenerative scoliosis in terms of clinical and radiological outcomes. Methods A total of 18 patients with ADS who underwent stand-alone OLIF in our hospital from July 2017 to May 2018 were enrolled in the study. Clinical evaluations were performed with visual analogue scale (VAS) and Oswestry Disability Index (ODI). Radiographic outcomes were recorded in terms of coronal Cobb angle and lumbar lordosis. Results Mean patient age was 62.4 years, 50% of patients were female. Average follow up was 18.4 months. The average operative duration was 87.4 minutes, whilst the mean estimated blood loss was 45.6 ml. Mean coronal Cobb angle corrected from preoperative 15.2° to the final follow-up 6.8° (p < 0.05); and mean lumbar lordosis improved from preoperative 30.0° to 39.4° (p < 0.05). Mean disc height increased from preoperative 0.7 cm to 1.1 cm at final follow-up (p < 0.05). Mean VAS improved from 5.5 to 2.2 (p < 0.05). The mean preoperative and the final follow-up Oswestry Disability Indices were 27.8% and 13.1% respectively (p < 0.05). Conclusions Stand-alone OLIF could be regarded as an efficient and safe option in the treatment of ADS for careful selected patients.

The Role of Hounsfield Unit in Intraoperative Endplate Violation and Delayed Cage Subsidence with Oblique Lateral Interbody Fusion

2021 ◽  
pp. 219256822110525
Author(s):  
Hao Wu ◽  
Jason Pui Yin Cheung ◽  
Teng Zhang ◽  
Zhi Shan ◽  
Xuyang Zhang ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Posterior Instrumentation ◽  
Case Series ◽  
Hounsfield Unit ◽  
Mineral Density ◽  
Lateral Interbody Fusion ◽  
Cage Subsidence ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Study Design Retrospective clinical case series. Objectives To investigate the risk factors for intraoperative endplate violations and delayed cage subsidence after oblique lateral interbody fusion (OLIF) surgery. Secondly, to examine whether low Hounsfield unit (HU) values at different regions of the endplate are associated with intraoperative endplate violation or delayed cage subsidence. Methods 61 patients (aged 65.1 ± 9.5 years; 107 segments) who underwent OLIF with or without posterior instrumentation from May 2015 to April 2019 were retrospectively studied. Intraoperative endplate violation was measured on sagittal reconstructed computerized tomography (CT) images immediate postoperatively, while delayed cage subsidence was evaluated using lateral radiographs and defined at 1-month follow-up or later. Demographic information and clinical parameters such as age, body mass index, bone mineral density, number of surgical levels, cage dimension, disc height restoration, visual analogue scale (VAS), and HU at different regions of the endplate were obtained. Results Total postoperative cage subsidence was identified in 45 surgical levels (42.0%) in 26 patients (42.6%) up till postoperative 1-year follow-up. Low HU value at the ipsilateral epiphyseal ring was an independent risk factor for intraoperative endplate violation ( P = .008) with a cut-off value of 326.21 HUs. Low HU values at the central endplate had a significant correlation with delayed cage subsidence in stand-alone cases ( P = .013) with a cut-off value of 296.42 HUs. VAS scores were not different at 1 week postoperatively in cases with or without intraoperative endplate violation (3.12 ± .73 vs 2.89 ± .72, P = .166) and showed no difference at 1 year with or without delayed cage subsidence (1.95 ± .60 vs 2.26 ± .85, P = .173). Conclusions Intraoperative endplate violation and delayed cage subsidence are not uncommon with OLIF surgery. HUs of the endplate are good predictors for intraoperative endplate violation and cage subsidence since they can represent the regional bone quality of the endplate in contact with the implant. VAS improvements were not affected by intraoperative endplate violation or delayed cage subsidence at 1-year follow-up. Level of Evidence Level III.

scholarly journals Outcomes of Oblique Lateral Interbody Fusion for Adult Spinal Deformity: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 219256822097914
Author(s):  
Lei Zhu ◽  
Jun-Wu Wang ◽  
Liang Zhang ◽  
Xin-Min Feng
Keyword(s):  
Systematic Review ◽  
Lumbar Lordosis ◽  
Interbody Fusion ◽  
Perioperative Complications ◽  
Adult Spinal Deformity ◽  
Meta Analysis ◽  
Fusion Rate ◽  
The Mean ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Study Design: A systematic review and meta-analysis. Objectives: To evaluate clinical and radiographic outcomes, and perioperative complications of oblique lateral interbody fusion (OLIF) for adult spinal deformity (ASD). Methods: We performed a systematic review and meta-analysis of related studies reporting outcomes of OLIF for ASD. The clinical outcomes were assessed by visual analogue scale (VAS) and Oswestry Disability Index (ODI). The radiographic parameters were evaluated by sagittal vertical axis (SVA), pelvic tilt (PT), sacral slope (SS), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence-lumbar lordosis (PI-LL), Cobb angle and fusion rate. A random effects model and 95% confidence intervals (CI) were performed to investigate the results. Results: A total of 16 studies involving 519 patients were included in the present study. The mean difference of VAS-back score, VAS-leg score and ODI score before and after surgery was 5.1, 5.0 and 32.3 respectively. The mean correction of LL was 20.6°, with an average of 6.9° per level and the mean correction of Cobb was 16.4°, with an average of 4.7° per level. The mean correction of SVA, PT, SS, TK and PI-LL was 59.3 mm, 11.7°, 6.9°, 9.4° and 20.6° respectively. The mean fusion rate was 94.1%. The incidence of intraoperative and postoperative complications was 4.9% and 29.6% respectively. Conclusions: OLIF is an effective and safe surgery method in the treatment of mild or moderate ASD and it has advantages in less intraoperative blood loss and lower perioperative complications.

scholarly journals Efficacy of Indirect Decompression in Lumbar Spinal Stenosis with Stand-alone Oblique Lateral Interbody Fusion

2020 ◽  
Author(s):  
Chen Liu ◽  
Quanlai Zhao ◽  
Yu Zhang ◽  
Liang Xiao ◽  
Xin Ge ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Interbody Fusion ◽  
Pedicle Screw Fixation ◽  
Lateral Interbody Fusion ◽  
Indirect Decompression ◽  
Lumbar Spinal ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Abstract Background Oblique lateral interbody fusion (OLIF) has been gained more and more attention in the treatment of degenerative lumbar disease. The goal of this study was to evaluate the effect of indirect decompression in lumbar spinal stenosis with stand-alone OLIF. Methods Sixty-three patients with lumbar spinal stenosis who underwent stand-alone OLIF between July 2017 and May 2018 our department were included. Clinical outcomes including visual analogue scale (VAS) and Oswestry Disability Index (ODI) were recorded. Radiographic outcomes comprising of disc height (DH), foraminal height (FH) and lumbar lordosis (LL) were measured. Intraoperative data and complications were collected. All the data were compared preoperatively and postoperatively. Results Eighty-two segments were fused in sixty-three patients using stand-alone OLIF. The average follow-up time was 21.9±3.5 months (range from 16 to 28 months). The DH increased from 0.9±0.3 cm preoperatively to 1.3±0.2 cm postoperatively, and the final follow-up was 1.1±0.2 cm (P < 0.01). The FH increased from 1.7±0.3 cm before surgery to 2.3±0.3 cm after surgery, but decreased to 2.1±0.3 cm at final follow-up (P < 0.01). The LL increased from 38.0°±15.6° before surgery to 42.7°±13.0° at the final follow-up (p<0.01). The VAS and ODI scores of all patients significantly improved at the final follow-up (p<0.01). The total complication rate was 30.2%. Only three patients received revision of posterior decompression and pedicle screw fixation. Conclusions Stand-alone OLIF is an effective option in selected patients with lumbar spinal stenosis.

Impact of sufficient contact between the autograft and endplate soon after surgery to prevent nonunion at 12 months following posterior lumbar interbody fusion

2020 ◽  
Vol 33 (6) ◽  
pp. 796-805
Author(s):  
Hiroki Ushirozako ◽  
Tomohiko Hasegawa ◽  
Shigeto Ebata ◽  
Tetsuro Ohba ◽  
Hiroki Oba ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Complete Fusion ◽  
Lumbar Interbody Fusion ◽  
Occupancy Rate ◽  
Screw Loosening ◽  
Translucent Zone ◽  
Cage Subsidence ◽  
The Mean

OBJECTIVENonunion after posterior lumbar interbody fusion (PLIF) is associated with poor long-term outcomes in terms of health-related quality of life. Biomechanical factors in the fusion segment may influence spinal fusion rates. There are no reports on the relationship between intervertebral union and the absorption of autografts or vertebral endplates. Therefore, the purpose of this retrospective study was to evaluate the risk factors of nonunion after PLIF and identify preventive measures.METHODSThe authors analyzed 138 patients who underwent 1-level PLIF between 2016 and 2018 (75 males, 63 females; mean age 67 years; minimum follow-up period 12 months). Lumbar CT images obtained soon after the surgery and at 6 and 12 months of follow-up were examined for the mean total occupancy rate of the autograft, presence of a translucent zone between the autograft and endplate (more than 50% of vertebral diameter), cage subsidence, and screw loosening. Complete intervertebral union was defined as the presence of both upper and lower complete fusion in the center cage regions on coronal and sagittal CT slices at 12 months postoperatively. Patients were classified into either union or nonunion groups.RESULTSComplete union after PLIF was observed in 62 patients (45%), while nonunion was observed in 76 patients (55%). The mean total occupancy rate of the autograft immediately after the surgery was higher in the union group than in the nonunion group (59% vs 53%; p = 0.046). At 12 months postoperatively, the total occupancy rate of the autograft had decreased by 5.4% in the union group and by 11.9% in the nonunion group (p = 0.020). A translucent zone between the autograft and endplate immediately after the surgery was observed in 14 and 38 patients (23% and 50%) in the union and nonunion groups, respectively (p = 0.001). The nonunion group had a significantly higher proportion of cases with cage subsidence and screw loosening at 12 months postoperatively in comparison to the union group (p = 0.010 and p = 0.009, respectively).CONCLUSIONSA lower occupancy rate of the autograft and the presence of a translucent zone between the autograft and endplate immediately after the surgery were associated with nonunion at 12 months after PLIF. It may be important to achieve sufficient contact between the autograft and endplate intraoperatively for osseous union enhancement and to avoid excessive absorption of the autograft. The achievement of complete intervertebral union may decrease the incidence of cage subsidence or screw loosening.

Radiographic and clinical evaluation of cage subsidence after stand-alone lateral interbody fusion

2013 ◽  
Vol 19 (1) ◽  
pp. 110-118 ◽  
Author(s):  
Luis Marchi ◽  
Nitamar Abdala ◽  
Leonardo Oliveira ◽  
Rodrigo Amaral ◽  
Etevaldo Coutinho ◽  
...  
Keyword(s):  
Lumbar Lordosis ◽  
Interbody Fusion ◽  
Disc Height ◽  
Standard Group ◽  
Lateral Interbody Fusion ◽  
Cage Subsidence ◽  
Grade Ii ◽  
Wide Group ◽  
Lateral Interbody

Object Indirect decompression of the neural structures through interbody distraction and fusion in the lumbar spine is feasible, but cage subsidence may limit maintenance of the initial decompression. The influence of interbody cage size on subsidence and symptoms in minimally invasive lateral interbody fusion is heretofore unreported. The authors report the rate of cage subsidence after lateral interbody fusion, examine the clinical effects, and present a subsidence classification scale. Methods The study was performed as an institutional review board–approved prospective, nonrandomized, comparative, single-center radiographic and clinical evaluation. Stand-alone short-segment (1- or 2-level) lateral lumbar interbody fusion was investigated with 12 months of postoperative follow-up. Two groups were compared. Forty-six patients underwent treatment at 61 lumbar levels with standard interbody cages (18 mm anterior/posterior dimension), and 28 patients underwent treatment at 37 lumbar levels with wide cages (22 mm). Standing lateral radiographs were used to measure segmental lumbar lordosis, disc height, and rate of subsidence. Subsidence was classified using the following scale: Grade 0, 0%–24% loss of postoperative disc height; Grade I, 25%–49%; Grade II, 50%–74%; and Grade III, 75%–100%. Fusion status was assessed on CT scanning, and pain and disability were assessed using the visual analog scale and Oswestry Disability Index. Complications and reoperations were recorded. Results Pain and disability improved similarly in both groups. While significant gains in segmental lumbar lordosis and disc height were observed overall, the standard group experienced less improvement due to the higher rate of interbody graft subsidence. A difference in the rate of subsidence between the groups was evident at 6 weeks (p = 0.027), 3 months (p = 0.042), and 12 months (p = 0.047). At 12 months, 70% in the standard group and 89% in the wide group had Grade 0 or I subsidence, and 30% in the standard group and 11% in wide group had Grade II or III subsidence. Subsidence was detected early (6 weeks), at which point it was correlated with transient clinical worsening, although progression of subsidence was not observed after the 6-week time point. Moreover, subsidence occurred predominantly (68%) in the inferior endplate. Fusion rate was not affected by cage dimension (p > 0.999) or by incidence of subsidence (p = 0.383). Conclusions Wider cages avoid subsidence and better restore segmental lordosis in stand-alone lateral interbody fusion. Cage subsidence is identified early in follow-up and can be accessed using the proposed classification scale.

Radiological and clinical outcomes following extreme lateral interbody fusion

2014 ◽  
Vol 20 (6) ◽  
pp. 623-635 ◽  
Author(s):  
Marjan Alimi ◽  
Christoph P. Hofstetter ◽  
Guang-Ting Cong ◽  
Apostolos John Tsiouris ◽  
Andrew R. James ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Large Population ◽  
Thoracolumbar Spine ◽  
Radiological Outcome ◽  
Lateral Interbody Fusion ◽  
Extreme Lateral Interbody Fusion ◽  
Lateral Interbody

Object Extreme lateral interbody fusion (ELIF) is a popular technique for anterior fixation of the thoracolumbar spine. Clinical and radiological outcome studies are required to assess safety and efficacy. The aim of this study was to describe the functional and radiological impact of ELIF in a degenerative disc disease population with a longer follow-up and to assess the durability of this procedure. Methods Demographic and perioperative data for all patients who had undergone ELIF for degenerative lumbar disorders between 2007 and 2011 were collected. Trauma and tumor cases were excluded. For radiological outcome, the preoperative, immediate postoperative, and latest follow-up coronal Cobb angle, lumbar sagittal lordosis, bilateral foraminal heights, and disc heights were measured. Pelvic incidence (PI) and PI–lumbar lordosis (PI-LL) mismatch were assessed in scoliotic patients. Clinical outcome was evaluated using the Oswestry Disability Index (ODI) and visual analog scale (VAS), as well as the Macnab criteria. Results One hundred forty-five vertebral levels were surgically treated in 90 patients. Pedicle screw and rod constructs and lateral plates were used to stabilize fixation in 77% and 13% of cases, respectively. Ten percent of cases involved stand-alone cages. At an average radiological follow-up of 12.6 months, the coronal Cobb angle was 10.6° compared with 23.8° preoperatively (p < 0.0001). Lumbar sagittal lordosis increased by 5.3° postoperatively (p < 0.0001) and by 2.9° at the latest follow-up (p = 0.014). Foraminal height and disc height increased by 4 mm (p < 0.0001) and 3.3 mm (p < 0.0001), respectively, immediately after surgery and remained significantly improved at the last follow-up. Separate evaluation of scoliotic patients showed no statistically significant improvement in PI and PI-LL mismatch either immediately postoperatively or at the latest follow-up. Clinical evaluation at an average follow-up of 17.6 months revealed an improvement in the ODI and the VAS scores for back, buttock, and leg pain by 21.1% and 3.7, 3.6, and 3.7 points, respectively (p < 0.0001). According to the Macnab criteria, 84.8% of patients had an excellent, good, or fair functional outcome. New postoperative thigh numbness and weakness was detected in 4.4% and 2.2% of the patients, respectively, which resolved within the first 3 months after surgery in all but 1 case. Conclusions This study provides what is to the authors' knowledge the most comprehensive set of radiological and clinical outcomes of ELIF in a fairly large population at a midterm follow-up. Extreme lateral interbody fusion showed good clinical outcomes with a low complication rate. The procedure allows for at least midterm clinically effective restoration of disc and foraminal heights. Improvement in coronal deformity and a small but significant increase in sagittal lordosis were observed. Nonetheless, no significant improvement in the PI-LL mismatch was achieved in scoliotic patients.

scholarly journals Curative Effect of Oblique Lateral Interbody Fusion in the Treatment of Lumbar Tuberculosis

2021 ◽  
Author(s):  
Wenhui Zhang ◽  
Weiqiang Sun ◽  
Yuanyuan Zhang ◽  
Fengguang Yang ◽  
Yuping Yang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Interbody Fusion ◽  
Operation Time ◽  
Curative Effect ◽  
Vas Score ◽  
Lateral Interbody Fusion ◽  
Antituberculous Drug ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Abstract Objective: This research aimed to investigate the curative effect of oblique lateral interbody fusion (OLIF) in the treatment of lumbar tuberculosis. Methods: A total of 32 patients, including 18 males and 14 females (29-58 years old, with the mean age of 47) who were admitted to our hospital from October 2016 to June 2020 and treated with oblique lateral interbody fusion combined with vertebral screw internal fixation, were retrospectively collected. The segmental distribution of lesions was L2- L316 cases, L3-L411 cases and L4-L55 cases. At first, preoperative antituberculous drug treatment was standardized for 2-4 weeks. Furthermore, intraoperative blood loss, operation time, postoperative complications, ESR, CRP, VAS, JOA and ASIA scores were recorded before and after surgery and at the last follow-up. In addition, antituberculous drug therapy was regulated continuously after surgery.Results: All patients were followed up for 12-17 months, with an average of 14 months. ① The average operation time was (132.5±21.4) min, and the intraoperative blood loss was (227.3±43.1) ml. ② Preoperative ESR was (74.56±15.43) mmol/h, and CRP was (43.21±19.37) mg/L. Seven days after surgery, ESR was (42.37±19.26) mmol/h, and CRP was (22.51±18.42) mg/L. In the last follow-up, ESR was (9.25±4.13) mmol/h, and CRP was (8.17±3.21) mg/L. They have statistically significant differences before surgery, seven days after the surgery and in the last follow-up (P<0.05). ③ The average VAS score before surgery was (7.21±1.40) points, the average JOA score was (18.24±4.13) points, the average VAS score seven days after surgery was (2.23±1.32) points, the average JOA score was (24.72±3.19) points, and the average VAS score in the last follow-up was (1.63±0.54) points. JOA score was (27.72±2.61). They have statistically significant differences before surgery, seven days after the surgery and in the last follow-up (P<0.05) ④Six patients had neurologic symptoms with ASIA grade D before surgery, 2 patients recovered to Grade E seven days after surgery, and the remaining 4 patients also recovered to grade E in the last follow-up. Besides, 26 patients were graded as Grade E before surgery, seven days after surgery and in the last follow-up. ⑤ After surgery, 1 patient suffered psoas major muscle damage, which was manifested as reduced hip flexion strength of the lower extremity, and returned to normal three weeks later. Apart from that, none of the patients had complications such as abdominal organ injury and poor wound healing. Conclusion: OLIF is a new minimally invasive method for treating lumbar tuberculosis, with short operation time, less blood loss, convenient operation, thorough removal of lesions, and good long-term follow-up effect. It is worthy of promotion and application.

scholarly journals Subsidence of Interbody Cage Following Oblique Lateral Interbody Fusion: An Analysis and Potential Risk Factors

2021 ◽  
pp. 219256822110672
Author(s):  
Vit Kotheeranurak ◽  
Khanathip Jitpakdee ◽  
Guang-Xun Lin ◽  
Akaworn Mahatthanatrakul ◽  
Weerasak Singhatanadgige ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Cohort ◽  
Interbody Fusion ◽  
Fatty Degeneration ◽  
Peek Cage ◽  
Multifidus Muscle ◽  
Cage Subsidence ◽  
Potential Risk Factors ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Study Design Retrospective cohort study Objectives This study aimed to report the incidence and potential risk factors of polyetheretherketone (PEEK) cage subsidence following oblique lateral interbody fusion (OLIF) for lumbar degenerative diseases. We proposed also an algorithm to minimize subsidence following OLIF surgery. Methods The study included a retrospective cohort of 107 consecutive patients (48 men and 59 women; mean age, 67.4 years) who had received either single- or multi-level OLIF between 2012 and 2019. Patients were classified into subsidence and non-subsidence groups. PEEK cage subsidence was defined as any violation of either endplate from the computed tomography scan in both sagittal and coronal views. Preoperative variables such as age, sex, body mass index, bone mineral density (BMD) measured by preoperative dual-energy X-ray absorptiometry, smoking status, corticosteroid use, diagnosis, operative level, multifidus muscle cross-sectional area, and multifidus muscle fatty degeneration were collected. Age-related variables (height and length) were also documented. Univariate and multivariate logistic regression analyses were used to analyze the risk factors of subsidence. Results Of the 107 patients (137 levels), 50 (46.7%) met the subsidence criteria. Higher PEEK cage height had the strongest association with subsidence (OR = 9.59, P < .001). Other factors significantly associated with cage subsistence included age >60 years (OR = 3.15, P = .018), BMD <−2.5 (OR = 2.78, P = .006), and severe multifidus muscle fatty degeneration (OR = 1.97, P = .023). Conclusions Risk factors for subsidence in OLIF were age >60 years, BMD < −2.5, higher cage height, and severe multifidus muscle fatty degeneration. Patients who had subsidence had worse early (3 months) postoperative back and leg pain.

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