Clinical Evaluation of Microendoscopy-Assisted Oblique Lateral Interbody Fusion

Background and objectives: Oblique Lateral Interbody Fusion (OLIF) is a widely performed, minimally invasive technique to achieve lumbar lateral interbody fusion. However, some complications can arise due to constraints posed by the limited surgical space and visual field. The purpose of this study was to assess the short-term postoperative clinical outcomes of microendoscopy-assisted OLIF (ME-OLIF) compared to conventional OLIF. Materials and Methods: We retrospectively investigated 75 consecutive patients who underwent OLIF or ME-OLIF. The age, sex, diagnosis, and number of fused levels were obtained from medical records. Operation time, estimated blood loss (EBL), and intraoperative complications were also collected. Operation time and EBL were only measured per level required for the lateral procedure, excluding the posterior fixation surgery. The primary outcome measure was assessed using the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). The secondary outcome measure was assessed using the Oswestry Disability Index (ODI) and the European Quality of Life–5 Dimensions (EQ-5D), measured preoperatively and 1-year postoperatively. Results: This case series consisted of 14 patients in the OLIF group and 61 patients in the ME-OLIF group. There was no significant difference between the two groups in terms of the mean operative time and EBL (p = 0.90 and p = 0.50, respectively). The perioperative complication rate was 21.4% in the OLIF group and 21.3% in the ME-OLIF group (p = 0.99). In both groups, the postoperative JOABPEQ, EQ-5D, and ODI scores improved significantly (p < 0.001). Conclusions: Although there was no significant difference in clinical results between the two surgical methods, the results suggest that both are safe surgical methods and that microendoscopy-assisted OLIF could serve as a potential alternative to the conventional OLIF procedure.

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Oblique Lateral Interbody Fusion Combined With Lateral Plate Fixation for the Treatment of Lumbar Degenerative Diseases: a Preliminary Clinical Study

10.21203/rs.3.rs-836768/v1 ◽

2021 ◽

Author(s):

Hai-dong Li ◽

Shi-Tong Xing ◽

Ji-Kang Min ◽

Xiang-Qian Fang ◽

Shun-Wu Fan

Keyword(s):

Blood Loss ◽

Interbody Fusion ◽

Plate Fixation ◽

Operation Time ◽

Degenerative Diseases ◽

Lateral Plate ◽

Lateral Interbody Fusion ◽

Lumbar Degenerative Diseases ◽

Oblique Lateral Interbody Fusion ◽

Lateral Interbody

Abstract Background The oblique lateral interbody fusion (OLIF) is a minimally invasive indirect decompression technique for the treatment of lumar spine disease. The OLIF has usually combined with supplemental posterior pedicle screw fixation for decreasing the perioperative complications. The purpose of this study was to evaluate clinical efficacy and complications of oblique lateral interbody fusion (OLIF) combined with lateral plate instrumentation for the treatment of lumbar degenerative diseases.Methods From May 2020 to August 2020, the clinical data of 20 patients who underwent OLIF combined with lateral plate instrumentation were retrospectively analyzed. The operation time, blood loss, and the complications were recorded. Also, the radiological parameters, Visual Analog Scale (VAS) score and Oswestry Disability Index (ODI) were evaluated before and after surgery.Results The average operation time, blood loss, and length of hospital stay were 75.41±11.53 min, 39.57±9.22 ml, and 7.22±1.85 days, respectively. The VAS and ODI had both significantly improved after surgery (7.23±1.26 VS 2.15±0.87; 60.27±7.91 VS 21.80±6.32, P < 0.001). The postoperative disk height (DH) was 13.02±8.83 mm, which is much higher than before (P < 0.001); The postoperative foraminal height (FH) improved significantly (16.18±3.49 VS 21.54±2.12 mm, P < 0.01), and the cross-sectional area (CSA) had improved from 88.95±14.79 mm2 to 126.53±8.83 mm2 (P < 0.001). The radiological fusion rate was 95% at the last follow-up, while cage subsidence was found in one case. No major complications, such as ureteral injury, vascular injury and vertebral body fracture occurred.Conclusions OLIF combined with lateral plate fixation can avoid the lumbar posterior surgery, minimize the operation time, blood loss and the posterior ligament complex disruption. It can realize one-stage intervertebral fusion and instrumentation through a single small incision.

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Curative Effect of Oblique Lateral Interbody Fusion in the Treatment of Lumbar Tuberculosis

10.21203/rs.3.rs-880038/v1 ◽

2021 ◽

Author(s):

Wenhui Zhang ◽

Weiqiang Sun ◽

Yuanyuan Zhang ◽

Fengguang Yang ◽

Yuping Yang ◽

...

Keyword(s):

Blood Loss ◽

Interbody Fusion ◽

Operation Time ◽

Curative Effect ◽

Vas Score ◽

Lateral Interbody Fusion ◽

Antituberculous Drug ◽

Oblique Lateral Interbody Fusion ◽

Lateral Interbody

Abstract Objective: This research aimed to investigate the curative effect of oblique lateral interbody fusion (OLIF) in the treatment of lumbar tuberculosis. Methods: A total of 32 patients, including 18 males and 14 females (29-58 years old, with the mean age of 47) who were admitted to our hospital from October 2016 to June 2020 and treated with oblique lateral interbody fusion combined with vertebral screw internal fixation, were retrospectively collected. The segmental distribution of lesions was L2- L316 cases, L3-L411 cases and L4-L55 cases. At first, preoperative antituberculous drug treatment was standardized for 2-4 weeks. Furthermore, intraoperative blood loss, operation time, postoperative complications, ESR, CRP, VAS, JOA and ASIA scores were recorded before and after surgery and at the last follow-up. In addition, antituberculous drug therapy was regulated continuously after surgery.Results: All patients were followed up for 12-17 months, with an average of 14 months. ① The average operation time was (132.5±21.4) min, and the intraoperative blood loss was (227.3±43.1) ml. ② Preoperative ESR was (74.56±15.43) mmol/h, and CRP was (43.21±19.37) mg/L. Seven days after surgery, ESR was (42.37±19.26) mmol/h, and CRP was (22.51±18.42) mg/L. In the last follow-up, ESR was (9.25±4.13) mmol/h, and CRP was (8.17±3.21) mg/L. They have statistically significant differences before surgery, seven days after the surgery and in the last follow-up (P<0.05). ③ The average VAS score before surgery was (7.21±1.40) points, the average JOA score was (18.24±4.13) points, the average VAS score seven days after surgery was (2.23±1.32) points, the average JOA score was (24.72±3.19) points, and the average VAS score in the last follow-up was (1.63±0.54) points. JOA score was (27.72±2.61). They have statistically significant differences before surgery, seven days after the surgery and in the last follow-up (P<0.05) ④Six patients had neurologic symptoms with ASIA grade D before surgery, 2 patients recovered to Grade E seven days after surgery, and the remaining 4 patients also recovered to grade E in the last follow-up. Besides, 26 patients were graded as Grade E before surgery, seven days after surgery and in the last follow-up. ⑤ After surgery, 1 patient suffered psoas major muscle damage, which was manifested as reduced hip flexion strength of the lower extremity, and returned to normal three weeks later. Apart from that, none of the patients had complications such as abdominal organ injury and poor wound healing. Conclusion: OLIF is a new minimally invasive method for treating lumbar tuberculosis, with short operation time, less blood loss, convenient operation, thorough removal of lesions, and good long-term follow-up effect. It is worthy of promotion and application.

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