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 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 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

scholarly journals S-line as Predictor of Clinical Outcome for Patients Undergone Transforaminal Lumbar Interbody Fusion for Lumbar Spinal Stenosis

2021 ◽  
Author(s):  
Yilin Lu ◽  
Jian Zhu ◽  
Xi Luo ◽  
Kaiqiang Sun ◽  
Jingchuan Sun ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Interbody Fusion ◽  
Sagittal Alignment ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Significant Difference ◽  
Lumbar Spinal

Abstract Background: Some have speculated that LSTV has an impact on lumbar curve. A retrospective study was conducted to evaluate S-line as predictor of clinical outcome for patients undergone transforaminal lumbar interbody fusion for lumbar spinal stenosis.Methods: 126 patients undergoing transforaminal lumbar interbody fusion were enrolled. S-line stands for the connecting line between the highest points of the iliac crests on both sides. The patients were divided into two groups according to the position of S-line, S-line (-) group included patients whose S-line were between L4 and L5, and S-line (+) group included patients whose S-line is above or below this range, which were divided into two subgroups. Their pre-operative imaging data about sagittal alignment were collected, including lumbar lordosis (LL), sacral slope (SS), pelvic incidence (PI) and pelvic tilt (PT). Clinical outcomes were measured using Japanese Orthopaedic Association (JOA) scores, the Oswestry disability index (ODI), visual analog scale (VAS) before the surgery and postoperatively. The correlation of S-line and clinical outcomes, as well as sagittal alignment and clinical outcomes, were analyzed.Results: LL, SS, PI, PT and PI minus(-) LL of S-line (-) group were (45.39°±12.68°), (30.27°±10.55°), (43.32°±12.22°), (13.05°±6.52°), (-2.07°±8.20°), respectively, and those parameters of S-line (+) group were (40.29±14.92), (35.70°±14.09°), (52.59°±17.07°), (16.89°±8.24°), (12.30°±9.98°), respectively. Significant difference were seen in the above parameters between S-line (-) and S-line (+) group. For S-line (-) and S-line (+) group, post-operative JOA score were (22.39±2.12), (20.26±2.46), post-operative VAS were (2.07±0.88), (3.14±1.47), the post-operative ODI were (8.36±3.28), (11.82±3.32), the improvement rate is (0.61±0.13), (0.55±0.15), Significant differences of those parameters are seen between S-line (-) group and S-line (+) group.Conclusion: S-line is a reliable predictor of clinical outcome for patients undergone transforaminal lumbar interbody fusion for lumbar spinal stenosis.

scholarly journals Full-Endoscopic Transforaminal Ventral Decompression for Symptomatic Thoracic Disc Herniation with or without Calcification: Technical Notes and Case Series

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Shangju Gao ◽  
Jingchao Wei ◽  
Wenyi Li ◽  
Long Zhang ◽  
Can Cao ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Clinical Outcomes ◽  
Disc Herniation ◽  
Average Length ◽  
Case Series ◽  
Operation Time ◽  
Leg Pain ◽  
Thoracic Disc Herniation ◽  
Open Operation ◽  
Thoracic Disc

Background. Symptomatic thoracic disc herniation is a challenge in spinal surgery, especially for cases with calcification. Traditional open operation has a high complication rate. The authors introduced a modified full-endoscopic transforaminal ventral decompression technique in this study and evaluated its imaging and clinical outcomes. Materials and Methods. Eleven patients with symptomatic thoracic disc herniation who underwent full-endoscopic transforaminal ventral decompression in a single medical center were enrolled. The surgical technique was performed as described in detail. Dilator sliding punching, endoscope-monitored foraminoplasty, and base cutting through the “safe triangle zone” are the key points of the technique. Clinical outcomes were assessed by the modified Japanese Orthopedic Association (mJOA) score for neurological improvement and the visual analogy score (VAS) for thoracic and leg pain. The operation time, hospital stay, and complications were also analyzed. Results. Postoperative magnetic resonance imaging (MRI) revealed good decompression of the spinal cord. The mJOA improved from 7.4 (range: 5–10) to 10.2 (range: 9–11). Axial thoracic pain improved in 8 of 9 patients. Leg pain and thoracic radicular pain improved in all patients. No complications were observed. The average operation time was 136 minutes (range: 70–180 minutes). The average length of hospital stay was 5.3 days (range: 2–8 days). Conclusion. Minimally invasive full-endoscopic transforaminal ventral decompression for the treatment of symptomatic thoracic disc herniation with or without calcification is feasible and may be another option for this challenging spine disease.

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.

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 Minimally Invasive Transforaminal Lumbar Interbody Fusion: An Attractive Option for Select Failed Backs

2018 ◽  
Vol 12 (1) ◽  
pp. 52-58 ◽  
Author(s):  
Arvind G. Kulkarni ◽  
Shashidhar Bangalore Kantharajanna ◽  
Abhilash N. Dhruv
Keyword(s):  
Back Pain ◽  
Blood Loss ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Percentage Change ◽  
Leg Pain ◽  
Lumbar Interbody Fusion ◽  
Vas Scores ◽  
The Mean

<sec><title>Study Design</title><p>Retrospective case series.</p></sec><sec><title>Purpose</title><p>To compare minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) outcomes in primary and revision surgeries.</p></sec><sec><title>Overview of Literature</title><p>Revision spinal fusion is often associated with an increased risk of approach-related complications. Patients can potentially benefit from the decreased approach-related morbidity associated with MI-TLIF.</p></sec><sec><title>Methods</title><p>Sixty consecutive MI-TLIF patients (20 failed back [Fa group], 40 primary [Pr group]) who underwent surgery between January 2011 and May 2012 were reviewed after Institutional Review Board approval to compare operative times, blood loss, complications, Oswestry Disability Index (ODI) scores, and Visual Analog Scale (VAS) scores for back and leg pain before surgery and at the last follow-up.</p></sec><sec><title>Results</title><p>Nineteen revision surgeries were compared with 36 primary surgeries. One failed back and four primary patients were excluded because of inadequate data. The mean follow-up times were 28 months and 24 months in the Pr and Fa groups, respectively. The mean pre- and postoperative ODI scores were 53.18 and 20.23 in the Pr group and 52.01 and 25.72 in the Fa group, respectively (ODI percentage change: Pr group, 60.36%±29.73%; Fa group, 69.32%±13.72%; <italic>p</italic>=0.304, not significant). The mean pre- and postoperative VAS scores for back pain were 4.77 and 1.75 in the Pr group and 4.1 and 2.0 in the Fa group, respectively, and the percentage changes were statistically significant (VAS back pain percentage change: Pr group, 48.78±30.91; Fa group, 69.32±13.72; <italic>p</italic>=0.027). The mean pre- and postoperative VAS scores for leg pain were 6.52 and 1.27 in the Pr group and 9.5 and 1.375 in the Fa group, respectively (VAS leg pain percentage change: Pr group, 81.07±29.39; Fa group, 75.72±15.26; <italic>p</italic>=0.538, not significant). There were no statistically significant differences in operative time and estimated blood loss and no complications.</p></sec><sec><title>Conclusions</title><p>MI-TLIF outcomes were comparable between primary and revision surgeries. The inherent technique of MI-TLIF is particularly suitable for select failed backs because it exploits the intact paramedian corridor.</p></sec>

scholarly journals Prevalence and location of endplate fracture and subsidence after oblique lumbar interbody fusion for adult spinal deformity

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Gen Inoue ◽  
Wataru Saito ◽  
Masayuki Miyagi ◽  
Takayuki Imura ◽  
Eiki Shirasawa ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Interbody Fusion ◽  
Sagittal Plane ◽  
Adult Spinal Deformity ◽  
Major Complication ◽  
Global Alignment ◽  
Lumbar Interbody Fusion ◽  
Significant Difference ◽  
Cage Subsidence ◽  
Oblique Lumbar Interbody Fusion

Abstract Background Recently, Oblique lumbar interbody fusion (OLIF) is commonly indicated to correct the sagittal and coronal alignment in adult spinal deformity (ASD). Endplate fracture during surgery is a major complication of OLIF, but the detailed location of fracture in vertebral endplate in ASD has not yet been determined. We sought to determine the incidence and location of endplate fracture and subsidence of the OLIF cage in ASD surgery, and its association with fusion status and alignment. Methods We analyzed 75 levels in 27 patients were analyzed using multiplanar CT to detect the endplate fracture immediately after surgery and subsidence at 1 year postoperatively. The prevalence was compared between anterior and posterior, approach and non-approach sides, and concave and convex side. Their association with fusion status, local and global alignment, and complication was also investigated. Results Endplate fracture was observed in 64 levels (85.3%) in all 27 patients, and the incidence was significantly higher in the posterior area compared with the anterior area (85.3 vs. 68.0%, p=0.02) of affected vertebra in the sagittal plane. In the coronal plane, there was no significant difference in incidence between left (approach) and right (non-approach) sides (77.3 and 81.3%, respectively), or concave and convex sides (69.4 and 79.6%) of wedged vertebra. By contrast, cage subsidence at 1 year postoperatively was noted in 14/75 levels (18.7%), but was not associated with endplate fracture. Fusion status, local and global alignment, and complications were not associated with endplate fracture or subsidence. Conclusion Endplate fracture during OLIF procedure in ASD cases is barely avoidable, possibly induced by the corrective maneuver with ideal rod counter and cantilever force, but is less associated with subsequent cage subsidence, fusion status, and sustainment of corrected alignment in long fusion surgery performed even for elderly patients.

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