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

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.

scholarly journals Posterior Fixation Can Further Improve the Segmental Alignment of Lumbar Degenerative Spondylolisthesis with Oblique Lumbar Interbody Fusion

2020 ◽  
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. Three radiographic parameters of disc height (DH), 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±1.6mm to 11.8±1.7mm (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±1.7mm to 11.8±2.3mm, p=1.000), 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.

scholarly journals Posterior fixation can further improve the segmental alignment of lumbar degenerative spondylolisthesis with Oblique Lumbar Interbody Fusion

2021 ◽  
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±1.6mm to 11.8±1.7mm (p<0.001), DH-Anterior was increased from 9.6±2.3mm to 13.4±2.1mm (p<0.001), DH-Posterior was increased from 6.1±1.9mm to 9.1±2.1mm (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±1.7mm to 11.8±2.3mm, p=1.000), DH-Anterior and DH-Posterior were slightly changed from 13.4±2.1mm and 9.1±2.1mm to 13.7±2.3mm and 8.4±1.8mm 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.

Factors Affecting Slip Reduction in Oblique Lumbar Interbody Fusion With Posterior Fixation for Degenerative Spondylolisthesis

2021 ◽  
pp. 219256822198929
Author(s):  
Nam-Su Chung ◽  
Han-Dong Lee ◽  
Chang-Hoon Jeon ◽  
Seungmin Jeong
Keyword(s):  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Large Angle ◽  
Surgical Techniques ◽  
Case Series ◽  
Posterior Fixation ◽  
Lumbar Interbody Fusion ◽  
Oblique Lumbar Interbody Fusion ◽  
The Mean

Study Design: Retrospective case series Objectives: Reduction of translational/angular slip is a favorable radiological result in spinal fusion for degenerative spondylolisthesis, although its clinical significance remains controversial. Few studies have investigated slip reduction and associated factors in oblique lumbar interbody fusion (OLIF) for degenerative spondylolisthesis. Methods: This study involved a retrospective analysis of 56 operated levels of 52 consecutive patients who underwent OLIF for degenerative spondylolisthesis and had more than 1-year of regular follow-up. Translational/angular slip, anterior/posterior disc height, and spinopelvic parameters were measured preoperatively, postoperatively at 6-weeks, and at the last follow-up. Demographic, radiological, and surgical parameters were analyzed to determine factors associated with the amount of slip reduction. Result: The mean follow-up duration was 30.4 ± 12.9 months (range, 12 to 61). The mean decrease in translational slip was 5.7 ± 2.1 mm (13.6 ± 5.5%) and the mean increase in angular slip was 7.9 ± 7.1° at the last follow-up (both P < 0.001). The amount of slip reduction was greater in female sex, age < 65 years, use of a 12° cage, cage position from the anterior disc margin of < 7 mm, and cases with posterior decompression (laminectomy with inferior facetectomy). Conclusions: OLIF showed satisfactory translational/angular slip reduction in degenerative spondylolisthesis. Surgical techniques for optimal reduction include the use of a large angle cage, anterior cage placement, and resection of the inferior facet.

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 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 Clinical and Radiological Outcomes of Lumbar Interbody Fusion Using a Combination of Hydroxyapatite and Demineralized Bone Matrix and Autografts for Lumbar Degenerative Spondylolisthesis

2017 ◽  
Vol 11 (5) ◽  
pp. 706-714 ◽  
Author(s):  
Asrafi Rizki Gatam ◽  
Luthfi Gatam ◽  
Singkat Dohar Lumban Tobing
Keyword(s):  
Interbody Fusion ◽  
Demineralized Bone Matrix ◽  
Bone Matrix ◽  
Japanese Orthopaedic Association ◽  
Degenerative Spondylolisthesis ◽  
Leg Pain ◽  
Lumbar Interbody Fusion ◽  
Computed Tomography Images ◽  
Lumbar Degenerative Spondylolisthesis ◽  
Demineralized Bone

<sec><title>Study Design</title><p>Prospective, cohort, non-inferiority study.</p></sec><sec><title>Purpose</title><p>This study evaluated the clinical and radiological outcomes of interbody fusion using a combination of demineralized bone matrix (DBM) and hydroxyapatite (HA).</p></sec><sec><title>Overview of Literature</title><p>The use of autografts remains a gold standard in lumbar interbody fusion, but the limited availability and donor site morbidity encourages the use of bone substitutes. In addition to autografts, a combination of HA and DBM is being increasingly use for lumbar interbody fusion. However, there are no data on the clinical and radiological outcomes of this procedure.</p></sec><sec><title>Methods</title><p>We examined 35 patients with lumbar degenerative spondylolisthesis who underwent transforaminal interbody fusion. Autografts were used in 18 patients, and 17 patients received a combination of HA and DBM. Clinical outcomes were evaluated using the visual analog scale (VAS) for back and leg pain, Oswestry disability index (ODI), and Japanese Orthopaedic Association (JOA) scores at 3, 6, and 12 months postoperatively. Fusion was evaluated using computed tomography images obtained at 12 months postoperatively.</p></sec><sec><title>Results</title><p>The mean ODI, JOA, and back and leg pain VAS scores increased significantly in both groups. However, the VAS, JOA, and ODI scores did not differ significantly between the two groups (<italic>p</italic>=0.599, <italic>p</italic>=0.543, and <italic>p</italic>=0.780, respectively). The fusion rates at 1 year postoperatively were 77.8% and 76.5% in the autograft and HA+DBM groups, respectively (<italic>p</italic>=0.99).</p></sec><sec><title>Conclusions</title><p>The clinical and radiological outcomes of using a combination of HA and DBM in lumbar interbody fusion were not inferior to those of using autografts. A combination of HA and DBM can be considered as an alternative in patients with lumbar degenerative spondylolisthesis requiring surgery.</p></sec>

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