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

Functional outcome analysis: instrumented posterior lumbar interbody fusion for degenerative lumbar scoliosis

2010 ◽  
Vol 153 (3) ◽  
pp. 547-555 ◽  
Author(s):  
Tai-Hsin Tsai ◽  
Tzuu-Yuan Huang ◽  
Ann-Shung Lieu ◽  
Kung-Shing Lee ◽  
Sui-Sum Kung ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Outcome Analysis ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Interbody Fusion ◽  
Lumbar Scoliosis ◽  
Functional Outcome Analysis

scholarly journals Transforaminal and Posterior Lumbar Interbody Fusion for Llumbar Degenerative Diseases, which one is better: A meta-analysis Through a Ggrade Analysis of Evidence

2021 ◽  
Author(s):  
aixian tian ◽  
xinlong ma ◽  
jianxiong Ma
Keyword(s):  
Blood Loss ◽  
Interbody Fusion ◽  
Meta Analysis ◽  
Posterior Lumbar Interbody Fusion ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Lumbar Interbody Fusion ◽  
Significant Difference

Abstract BackgroundTo explore the efficacy and safety between posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of lumbar degenerative diseases.MethodsWe searched the literature in Pubmed, Embase, Cochrane Library and Web of Science. The index words were posterior lumbar interbody fusion, PLIF, transforaminal lumbar interbody fusion, TLIF, lumbar interbody fusion, spinal fusion, degenerative disc disease and lumbar degenerative diseases. Primary outcomes were fusion rate and complications. Secondary outcomes were visual analog scale (ΔVAS), Oswestry Disability Index (ΔODI), total blood loss, operation time and length of hospital stay. Review Manager 5.3 and Stata13.1 was used for the analysis of forest plots, heterogeneity, sensitivity and publication bias.Results17 studies were included (N=1562; PLIF, n=835; TLIF, n=727). The pooled data showed PLIF had a higher complications (P= 0.000), especially in nerve injury (p = 0.003) and dural tear (p = 0.005). PLIF required longer operation time (p = 0.004), more blood loss (p = 0.000) and hospital stays (p = 0.006). Surprisingly subgroup analysis showed there was significant difference in complications in patients under 55 (p = 0.000) and Asian countries (p = 0.000). No statistical difference was found between the two groups with regard to fusion rate (p = 0.593),ΔVAS (p = 0.364) andΔODI (p = 0.237).ConclusionsThis meta-analysis showed there were no significant difference in fusion rate, ΔVAS and ΔODI. However TLIF could reduce complications, especially nerve injury and dural tear. Besides, TLIF was associated with statistically significant less blood loss, shorter operation time and shorter length of hospital stay.

Instrumented Posterior Lumbar Interbody Fusion for Patients With Degenerative Lumbar Scoliosis

2008 ◽  
Vol 21 (5) ◽  
pp. 310-315 ◽  
Author(s):  
Chin-Hsien Wu ◽  
Chak-Bor Wong ◽  
Lih-Huei Chen ◽  
Chi-Chien Niu ◽  
Tung-Ting Tsai ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Interbody Fusion ◽  
Lumbar Scoliosis

scholarly journals Cortical Bone Trajectory Screws in Posterior Lumbar Interbody Fusion: Minimally Invasive Surgery for Maximal Muscle Sparing—A Prospective Comparative Study with the Traditional Open Technique

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Nicola Marengo ◽  
Marco Ajello ◽  
Michele Federico Pecoraro ◽  
Giulia Pilloni ◽  
Giovanni Vercelli ◽  
...  
Keyword(s):  
Comparative Study ◽  
Interbody Fusion ◽  
Pedicle Screws ◽  
Posterior Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Lumbar Interbody Fusion ◽  
Significant Difference ◽  
Prospective Comparative Study ◽  
One Year ◽  
Muscular Damage

Introduction. A prospective comparative study between classical posterior interbody fusion with peduncular screws and the new technique with divergent cortical screws was conducted. Material and Methods. Only patients with monosegmental degenerative disease were recruited into this study. We analyzed a cohort of 40 patients treated from January 2015 to March 2016 divided into 2 groups (20 patients went to traditional open surgery and 20 patients under mini-invasive strategy). Primary endpoints of this study are fusion rate and muscular damage; secondary endpoints analyzed were three different clinical scores (ODI, VAS, and EQ) and the morbidity rate of both techniques. Results. There was no significant difference in fusion rate between the two techniques. In addition, a significant difference in muscular damage was found according to the MRI evaluation. Clinical outcomes, based on pain intensity, Oswestry Disability Index status, and Euroquality-5D score, were found to be also statistically different, even one year after surgery. This study also demonstrated a correlation between patients’ muscular damage and their clinical outcome. Conclusions. Cortical bone trajectory screws would provide similar outcomes compared to pedicle screws in posterior lumbar interbody fusion at one year after surgery, and this technique represents a reasonable alternative to pedicle screws.

scholarly journals Does Atherosclerosis Have Negative Impacts on Early Adjacent Segment Degeneration After Posterior Lumbar Interbody Fusion?

2020 ◽  
pp. 219256822091937
Author(s):  
Hironobu Sakaura ◽  
Daisuke Ikegami ◽  
Takahito Fujimori ◽  
Tsuyoshi Sugiura ◽  
Yoshihiro Mukai ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Interbody Fusion ◽  
Surrogate Marker ◽  
Posterior Lumbar Interbody Fusion ◽  
Adjacent Segment Degeneration ◽  
Adjacent Segment ◽  
Lumbar Interbody Fusion ◽  
Significant Difference ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Negative Impacts

Study Design: Retrospective study. Objective: To examine whether atherosclerosis has negative impacts on early adjacent segment degeneration (ASD) after posterior lumbar interbody fusion using traditional trajectory pedicle screw fixation (TT-PLIF). Methods: The subjects were 77 patients who underwent single-level TT-PLIF for degenerative lumbar spondylolisthesis. Using dynamic lateral radiographs of the lumbar spine before surgery and at 3 years postoperatively, early radiological ASD (R-ASD) was examined. Early symptomatic ASD (S-ASD) was diagnosed when neurologic symptoms deteriorated during postoperative 3-year follow-up and the responsible lesions adjacent to the fused segment were also confirmed on magnetic resonance imaging. According to the scoring system by Kauppila et al, the abdominal aortic calcification score (AAC score: a surrogate marker of systemic atherosclerosis) was assessed using preoperative lateral radiographs of the lumbar spine. Results: The incidence of early R-ASD was 41.6% at the suprajacent segment and 8.3% at the subjacent segment, respectively. Patients with R-ASD had significantly higher AAC score than those without R-ASD. The incidence of early S-ASD was 3.9% at the suprajacent segment and 1.4% at the subjacent segment, respectively. Patients with S-ASD had higher AAC score than those without S-ASD, although there was no significant difference. Conclusions: At 3 years after surgery, the advanced AAC had significantly negative impacts on early R-ASD after TT-PLIF. This result indicates that impaired blood flow due to atherosclerosis can aggravate degenerative changes at the adjacent segments of the lumbar spine after PLIF.

scholarly journals Topping-Off Technology versus Posterior Lumbar Interbody Fusion in the Treatment of Lumbar Disc Herniation: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Wei Wang ◽  
Xiangyao Sun ◽  
Tongtong Zhang ◽  
Siyuan Sun ◽  
Chao Kong ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Adjacent Segment Disease ◽  
Adjacent Segment ◽  
Complication Rates ◽  
Lumbar Interbody Fusion ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Reoperation Rates ◽  
Topping Off

The treatment effects of topping-off technique were still controversial. This study compared all available data on postoperative clinical and radiographic outcomes of topping-off technique and posterior lumbar interbody fusion (PLIF). PubMed, EMBASE, and Cochrane were systematically reviewed. Variations included radiographical adjacent segment disease (RASD), clinical adjacent segment disease (CASD), global lumbar lordosis (GLL), visual analogue scale (VAS) of back (VAS-B) and leg (VAS-L), Oswestry disability index (ODI), Japanese Orthopaedic Association (JOA) score, duration of surgery, estimated blood loss (EBL), reoperation rates, and complication rates. Sixteen studies, including 1372 cases, were selected for the analysis. Rates of proximal RASD (P=0.0004), distal RASD (P=0.03), postoperative VAS-B (P=0.0001), postoperative VAS-L (P=0.02), EBL (P=0.007), and duration of surgery (P=0.02) were significantly lower in topping-off group than those in PLIF group. Postoperative ODI after 3 years (P=0.04) in the topping-off group was significantly less than that in the PLIF group. There was no significant difference in the rates of CASD (P=0.06), postoperative GLL (P=0.14), postoperative ODI within 3 years (P=0.24), and postoperative JOA (P=0.70) and in reoperation rates (P=0.32) and complication rates (P=0.27) between topping-off group and PLIF. The results confirmed that topping-off technique could effectively prevent ASDs after lumbar internal fixation. However, this effect is effective in preventing RASD. Topping-off technique is more effective in improving the subjective feelings of patients rather than objective motor functions compared with PLIF. With the development of surgical techniques, both topping-off technique and PLIF are safe.

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.

scholarly journals Adjacent Segment Disease After Posterior Lumbar Interbody Fusion: A Case Series of 1000 Patients

2018 ◽  
Vol 8 (7) ◽  
pp. 722-727 ◽  
Author(s):  
Shinya Okuda ◽  
Tomoya Yamashita ◽  
Tomiya Matsumoto ◽  
Yukitaka Nagamoto ◽  
Tsuyoshi Sugiura ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Posterior Lumbar Interbody Fusion ◽  
Adjacent Segment Disease ◽  
Adjacent Segment ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Interbody Fusion ◽  
Time Period ◽  
Time Periods

Study Design: Retrospective study. Objective: There have been few reports of adjacent segment disease (ASD) after posterior lumbar interbody fusion (PLIF) with large numbers and long follow-up. The purpose of this study was to investigate (1) ASD incidence and time periods after primary PLIF, (2) repeat ASD incidence and time periods, and (3) ASD incidence and time periods by fusion length, age, and preoperative pathologies. Methods: A total of 1000 patients (average age 67 years, average follow-up 8.3 years) who underwent PLIF for degenerative lumbar disorders were reviewed. ASD was defined as a symptomatic condition in which revision surgery was required. Results: The overall ASD rate was 9.0%, and the average ASD period was 4.7 years after primary surgery. With respect to clinical features of ASD, degenerative spondylolisthesis at the cranial fusion segment was the most frequent. In terms of repeat ASD, second and third ASD incidences were 1.1% and 0.4%, respectively. As for ASD by fusion length, age, and preoperative pathologies, ASD incidence was increased by fusion length, while the time period to ASD was significantly shorter in elderly patients and those with degenerative lumbar scoliosis. Conclusions: In the present study, the overall ASD incidence was 9.0%, and the average ASD period was 4.7 years after primary operation. Second and third ASD incidences were 1.1% and 0.4%, respectively. Fusion length affected the ASD incidence, while aging factor and preoperative pathology affected the ASD time period.

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