scholarly journals Simultaneous Robotic Single Position Oblique Lumbar Interbody Fusion With Bilateral Sacropelvic Fixation in Lateral Decubitus

Neurospine ◽  
2021 ◽  
Vol 18 (2) ◽  
pp. 406-412
Author(s):  
Martin H. Pham ◽  
Luis Daniel Diaz-Aguilar ◽  
Vrajesh Shah ◽  
Michael Brandel ◽  
Joshua Loya ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Sacropelvic Fixation ◽  
Oblique Lumbar Interbody Fusion ◽  
Lateral Decubitus

scholarly journals Changes in the Operative Corridor in Oblique Lumbar Interbody Fusion Between Preoperative Imaging and Intraoperative Cone-Beam Computed Tomography Using Morphometric Analysis

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Aqib Zehri ◽  
Hector Enrique Soriano-Baron ◽  
Wesley Hsu ◽  
Matthew Neal ◽  
Jonathan L Wilson
Keyword(s):  
Computed Tomography ◽  
Mr Imaging ◽  
Interbody Fusion ◽  
Lateral Decubitus Position ◽  
Cone Beam ◽  
Preoperative Imaging ◽  
Invasive Technique ◽  
Lumbar Interbody Fusion ◽  
Oblique Lumbar Interbody Fusion ◽  
Lateral Decubitus

Abstract INTRODUCTION Oblique lumbar interbody fusion (OLIF) is a minimally-invasive technique that relies on a sufficient corridor anterior to the psoas and posterior to vascular structures.This intraoperative corridor is evaluated on preoperative computed tomography (CT) and/or magnetic resonance (MR) imaging to guide patient selection.Previous cadaveric studies and preoperative MR imaging analysis have examined this corridor to determine corridor variations along right- and left-sided approaches and among patient characteristics.This is the first study that directly evaluates the true intraoperative corridor in the lateral decubitus position based on intraoperative 3D imaging. METHODS We performed a retrospective evaluation identifying patients > 18 yr old who had undergone an OLIF via a left-sided approach at 2 tertiary care centers from 2016 to 2018. Patients with scoliosis greater than 20 degrees, transitional anatomy, and psoas abnormalities were excluded.We recorded demographics and the intraoperative corridor defined by the distance between the left lateral border of the aorta or iliac vessels and anteromedial border of the psoas from L1-L2 through L4-5 disc spaces.This corridor was measured on supine, preoperative MR axial imaging and subsequent intraoperative 3D cone beam CT acquired in the right lateral decubitus position. RESULTS A total of 33 patients, 15 of whom were female, were included in this study.The average age was 65.4 and body mass index (BMI) was 31 kg/m2.There was a statistically significant increase (P < .05) in the intraoperative corridor from supine to lateral decubitus positioning at all levels.The greatest increase in corridor size was noted at L1-2 (3.1 cm) and least at L4-5 (2.1 cm).There was no statistically significant difference between age, BMI, or gender in the preoperative versus intraoperative corridor. CONCLUSION This is the first study to provide objective evidence to support that lateral decubitus positioning increases the intraoperative corridor for anterior to the psoas techniques.This information should increase confidence with an anterior to the psoas approach if there is adequate corridor size on supine preoperative imaging evaluation.

Simultaneous Robotic Single Position Surgery (SR-SPS) with Oblique Lumbar Interbody Fusion: A Case Series

2021 ◽  
Author(s):  
Luis Daniel Diaz-Aguilar ◽  
Vrajesh Shah ◽  
Alexander Himstead ◽  
Nolan J. Brown ◽  
Mickey E. Abraham ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Case Series ◽  
Lumbar Interbody Fusion ◽  
Oblique Lumbar Interbody Fusion

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

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.

Ventral Dural Injury After Oblique Lumbar Interbody Fusion

2017 ◽  
Vol 98 ◽  
pp. 881.e1-881.e4 ◽  
Author(s):  
JaeChil Chang ◽  
Jin-Sung Kim ◽  
Hyunjin Jo
Keyword(s):  
Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Oblique Lumbar Interbody Fusion
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