scholarly journals Comparison of Simultaneous Single-position Oblique Lumbar Interbody Fusion and Percutaneous Pedicle Screw Fixation with Posterior Lumbar Interbody Fusion using O-arm Navigated C-arm free Technique for Lumbar Degenerative Diseases

2021 ◽  
Author(s):  
Ying Tan ◽  
Masato Tanaka ◽  
Sumeet Sonawane ◽  
Koji Uotani ◽  
Yoshiaki Oda ◽  
...  
Keyword(s):  
Blood Loss ◽  
Pedicle Screw ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Surgical Time ◽  
Intraoperative Radiation ◽  
Percutaneous Pedicle Screw ◽  
Indirect Decompression ◽  
Oblique Lumbar Interbody Fusion

Abstract Background: To compare the clinical, surgical and radiographic outcomes of O-arm navigated C-arm free, simultaneous single-position oblique lumbar interbody fusion (OLIF) and percutaneous pedicle screw (PPS) fixation with minimally invasive posterior/ transforaminal lumbar interbody fusion (MI-PLIF/TLIF).Methods: This is retrospective comparative study. The study included 98 patients, 63 in single position OLIF (group SO) and 35 in MI-PLIF/TLIF (group P/T). Surgical time, blood loss, mobilization time after surgery and complications were analyzed for all patients. Clinical evaluation included visual analog scale (VAS) for back pain, oswestry disability index (ODI). Radiological parameters included cage height (CH), cage to disc ratio (CDR), DH change, pre and postoperative disc height (DH), foraminal height (FH), foraminal area (FA), segmental lordosis (SL). Results: In group SO (vs group P/T), surgical time, blood loss and mobilization time were 117.7± 34.1 minutes (171.8 ± 40.6 minutes, p<0.000001), 139.2 ± 82.0 ml (vs. 374.2 ± 247.7 ml, p<0.000001) and 2.7 ±1 .0 days (vs 3.9 ± 2.4 days, p<0.000001) respectively. The CH, CDR, DH change and postoperative DH, FH, FA increase were statistically significant in group SO compared to group P/T. VAS and ODI improvement were similar in both groups. Mobilization time is shorter in group SO. Total complication rate in group SO was 7% while that in group P/T was 11%. Conclusions: Simultaneous single position O-arm navigated C-arm free OLIF reduces the surgical time, blood loss, mobilization time after operation without the risk of an adverse event of intraoperative radiation to operating staff. Good indirect decompression can be achieved with this method. Clinical results were similar in both groups.

scholarly journals Lateral lumbar interbody fusion after reduction using the percutaneous pedicle screw system in the lateral position for Meyerding grade II spondylolisthesis: a preliminary report of a new lumbar reconstruction strategy

2021 ◽  
Author(s):  
Masanari Takami ◽  
Ryo Taiji ◽  
Motohiro Okada ◽  
Akihito Minamide ◽  
Hiroshi Hashizume ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Interbody Fusion ◽  
Visual Analog Scale Score ◽  
Lateral Position ◽  
Lumbar Interbody Fusion ◽  
Lateral Lumbar Interbody Fusion ◽  
Percutaneous Pedicle Screw ◽  
Indirect Decompression ◽  
Grade Ii ◽  
The Mean

Abstract Background: Utilization of a cage with a large footprint in lateral lumbar interbody fusion (LLIF) for the treatment of spondylolisthesis leads to a high fusion rate and neurological improvement owing to the indirect decompression effect and excellent alignment correction. However, if an interbody space is too narrow for insertion of an LLIF cage for cases of spondylolisthesis of Meyerding grade II or higher, LLIF cannot be used. Therefore, we developed a novel strategy, LLIF after reduction by the percutaneous pedicle screw (PPS) insertion system in the lateral position (LIFARL), for surgeons to perform accurate and safe LLIF with PPS in patients with such pathology. This study aimed to introduce the new surgical strategy and to present preliminary clinical and radiological results of patients with spondylolisthesis of Meyerding grade II.Methods: Six consecutive patients (four men and two women; mean age, 72.7 years-old; mean follow-up period, 15.3 months) with L4 spondylolisthesis of Meyerding grade II were included. Regarding the surgical procedure, first, PPSs were inserted into the L4 and L5 vertebrae fluoroscopically, and both rods were placed in the lateral position. The L5 set screws were fixed tightly, and the L4 side of the rod was floated. Second, the L4 vertebra was reduced by fastening the L4 set screws so that they expanded the anteroposterior width of the interbody space. At that time, the L4 set screws were not fully tightened to the rods to prevent the endplate injury. Finally, the LLIF procedure was started. After inserting the cage, a compression force was added to the PPSs, and the L4 set screws were completely fastened. Results: The mean operative time was 183 min, and the mean blood loss was 90.8 mL. All cages were positioned properly. Visual analog scale score and Oswestry disability index improved postoperatively. Bone union was observed using computed tomography 12 months after surgery.Conclusion: For cases with difficulty in LLIF cage insertion for Meyerding grade II spondylolisthesis due to the narrow anteroposterior width of interbody space, LIFARL is an option to achieve LLIF combined with posterior PPS accurately and safely.Trial registration: UMIN-Clinical Trials Registry, UMIN000040268, Registered 29 April 2020, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000045938

scholarly journals Lateral Lumbar Interbody Fusion After Reduction Using the Percutaneous Pedicle Screw System in the Lateral Position for Meyerding Grade II Spondylolisthesis: A Preliminary Report of a New Lumbar Reconstruction Strategy

2020 ◽  
Author(s):  
Masanari Takami ◽  
Ryo Taiji ◽  
Motohiro Okada ◽  
Akihito Minamide ◽  
Hiroshi Hashizume ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Interbody Fusion ◽  
Visual Analog Scale Score ◽  
Lateral Position ◽  
Lumbar Interbody Fusion ◽  
Lateral Lumbar Interbody Fusion ◽  
Percutaneous Pedicle Screw ◽  
Indirect Decompression ◽  
Grade Ii ◽  
The Mean

Abstract Background:Utilization of a cage with a large footprint in lateral lumbar interbody fusion(LLIF) for the treatment of spondylolisthesisleads to a high fusion rate and neurological improvement owing to the indirect decompression effect and excellent alignment correction. However, if an interbody space is too narrow for insertion of an LLIF cage for cases of spondylolisthesis of Meyerding grade II or higher, LLIF cannot be used. Therefore, we developed a novel strategy, LLIF after reduction by the percutaneous pedicle screw (PPS) insertion system in the lateral position (LIFARL), for surgeons to perform accurate and safe LLIF with PPS in patients with such pathology. This study aimed to introduce the new surgical strategy and to present preliminary clinical and radiological resultsof patients with spondylolisthesis of Meyerding grade II.Methods:Six consecutive patients (four men and two women; mean age, 72.7 years-old; mean follow-up period, 12.3 months) with L4 spondylolisthesis of Meyerding grade II were included. Regarding the surgical procedure, first, PPSs were inserted into the L4 and L5 vertebrae fluoroscopically, and both rodswere placed in the lateral position. The L5 set screws were fixed tightly, and the L4 side of the rod was floated. Second, the L4 vertebra was reduced by fastening the L4 set screws sothat they expanded the anteroposterior width of the interbody space.At that time, the L4 set screws were not fully tightened to the rods to prevent the endplate injury. Finally, the LLIF procedure was started. After inserting the cage, a compression force was added to the PPSs, and the L4 set screws were completely fastened. Results:The mean operative time was 183 min, and the mean blood loss was 90.8 mL. All cages were positioned properly. Visual analog scale score and Oswestry disability index improved postoperatively. Bone union was observed in all four patients who could be followed up for more than 12 months.Conclusion:For cases with difficulty in LLIF cage insertion for Meyerding grade II spondylolisthesis due tothe narrow anteroposterior width of interbody space, LIFARL is an option to achieve LLIF combined with posterior PPS accurately and safely.Trial registration:UMIN-Clinical Trials Registry, UMIN000040268,Registered 29 April 2020,https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000045938

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 Outcomes between Indirect Decompression of Oblique Lumbar Interbody Fusion and MIS-TLIF in One Single-level Lumbar Spondylosis: a case control study

2020 ◽  
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 ◽  
Anterolateral Approach ◽  
Lumbar Interbody Fusion ◽  
Single Level ◽  
Study Results ◽  
Indirect Decompression ◽  
Oblique Lumbar Interbody Fusion

Abstract Background Minimal 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). Methods Between December 2016 and September 2018, patients with single level degenerative spondylosis were selected to enroll in this retrospective study. Results 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). Conclusions Both OLIF and MIS-TLIF are becoming a mainstream procedure for lumbar degenerative-related disease, especially for spondylolisthesis. However, OLIF has shown to have less perioperative blood loss and shorter surgery time than that of MIS-TLIF. In addition, OLIF gives superior clinical and radiographic outcomes. While both OLIF and MIS-TLIF provide optimal clinical outcomes, upon comparison between the two techniques, the anterolateral approach of OLIF seems to be a superior option in modern day.

scholarly journals Lateral lumbar interbody fusion after reduction using the percutaneous pedicle screw system in the lateral position for Meyerding grade II spondylolisthesis: a preliminary report of a new lumbar reconstruction strategy

2020 ◽  
Author(s):  
Masanari Takami ◽  
Ryo Taiji ◽  
Motohiro Okada ◽  
Akihito Minamide ◽  
Hiroshi Hashizume ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Interbody Fusion ◽  
Visual Analog Scale Score ◽  
Lateral Position ◽  
Lumbar Interbody Fusion ◽  
Lateral Lumbar Interbody Fusion ◽  
Percutaneous Pedicle Screw ◽  
Indirect Decompression ◽  
Grade Ii ◽  
The Mean

Abstract Background: Utilization of a cage with a large footprint in lateral lumbar interbody fusion (LLIF) for the treatment of spondylolisthesis leads to a high fusion rate and neurological improvement owing to the indirect decompression effect and excellent alignment correction. However, if an interbody space is too narrow for insertion of an LLIF cage for cases of spondylolisthesis of Meyerding grade II or higher, LLIF cannot be used. Therefore, we developed a novel strategy, LLIF after reduction by the percutaneous pedicle screw (PPS) insertion system in the lateral position (LIFARL), for surgeons to perform accurate and safe LLIF with PPS in patients with such pathology. This study aimed to introduce the new surgical strategy and to present preliminary clinical and radiological results of patients with spondylolisthesis of Meyerding grade II.Methods: Six consecutive patients (four men and two women; mean age, 72.7 years-old; mean follow-up period, 15.3 months) with L4 spondylolisthesis of Meyerding grade II were included. Regarding the surgical procedure, first, PPSs were inserted into the L4 and L5 vertebrae fluoroscopically, and both rods were placed in the lateral position. The L5 set screws were fixed tightly, and the L4 side of the rod was floated. Second, the L4 vertebra was reduced by fastening the L4 set screws so that they expanded the anteroposterior width of the interbody space. At that time, the L4 set screws were not fully tightened to the rods to prevent the endplate injury. Finally, the LLIF procedure was started. After inserting the cage, a compression force was added to the PPSs, and the L4 set screws were completely fastened. Results: The mean operative time was 183 min, and the mean blood loss was 90.8 mL. All cages were positioned properly. Visual analog scale score and Oswestry disability index improved postoperatively. Bone union was observed using computed tomography 12 months after surgery.Conclusion: For cases with difficulty in LLIF cage insertion for Meyerding grade II spondylolisthesis due to the narrow anteroposterior width of interbody space, LIFARL is an option to achieve LLIF combined with posterior PPS accurately and safely.Trial registration: UMIN-Clinical Trials Registry, UMIN000040268, Registered 29 April 2020, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000045938

Sign in / Sign up

Export Citation Format

Share Document