oblique lumbar interbody fusion
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Medicine ◽  
2021 ◽  
Vol 100 (50) ◽  
pp. e28095
Author(s):  
Tae-Kyu Lee ◽  
Jae-Young Kim ◽  
Moon-Soo Han ◽  
Jung-Kil Lee ◽  
Bong Ju Moon

2021 ◽  
Author(s):  
Yinge Wang ◽  
Jiajia Wang ◽  
Sha Tu ◽  
Shuang Li ◽  
Jiangpu Yi ◽  
...  

Abstract Objective: Oblique lateral locking plate system (OLLPS) with the locking and reverse pedicle track screw configuration is a novel internal fixation designed for oblique lumbar interbody fusion(OLIF). It is placed in a single-position through the oblique lateral surgical corridor to reduce operative time and subsequent complications of prolonged anesthesia and prone positioning. The purpose of this study was to verify the biomechanical effect of OLLPS.Methods: The intact finite element model of L1–S1(Intact) was established based on CT images of a healthy male volunteer. The L4-L5 intervertebral space was selected as the surgical segment. The surgical models were established separately according to the OLIF surgical procedures and the different internal fixations: (1) stand-alone OLIF (SA); (2) OLIF with 2-screw lateral plate (LP-2); (3) OLIF with 4-screw lateral plate (LP-4); (4) OLIF with OLLPS (OLLPS); and (5) OLIF with bilateral pedicle screw fixation (BPS). After validating the intact model, the physiological loading was applied to the superior surface of L1 to simulate flexion, extension, left bending, right bending, left rotation, and right rotation motions. The evaluation indexes included the L4/5 range of motion (ROM), the L4 maximum displacement, and the maximum stress of the superior and inferior endplate, cage, and supplemental fixation.Results: In OLIF surgery, OLLPS provided multiplanar stability which was similar to that of BPS. Compared with LP-2 and LP-4, OLLPS had the better biomechanical properties in enhancing the instant stability of the surgical segment, reducing the stress of the superior and inferior endplates of the surgical segment, and reducing the risk of cage subsidence.Conclsions: With the minimally invasive background, OLLPS can be an alternative to BPS in OLIF and has a better prospect of clinical promotion and application.


2021 ◽  
Author(s):  
Ying Tan ◽  
Masato Tanaka ◽  
Sumeet Sonawane ◽  
Koji Uotani ◽  
Yoshiaki Oda ◽  
...  

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.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Gen Inoue ◽  
Wataru Saito ◽  
Masayuki Miyagi ◽  
Takayuki Imura ◽  
Eiki Shirasawa ◽  
...  

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.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Tenghui Ge ◽  
Jintao Ao ◽  
Guanqing Li ◽  
Zhao Lang ◽  
Yuqing Sun

Abstract Background For lumbar degenerative diseases, cage subsidence is a serious complication and can result in the failure of indirect decompression in the oblique lumbar interbody fusion (OLIF) procedure. Whether additional lateral plate fixation was effective to improve clinical outcomes and prevent cage subsidence was still unknown. This study aimed to compare the incidence and degree of cage subsidence between stand-alone oblique lumbar interbody fusion (SA-OLIF) and OLIF combined with lateral plate fixation (OLIF + LP) for the treatment of lumbar degenerative diseases and to evaluate the effect of the lateral plate fixation. Methods This was a retrospective comparative study. 20 patients with 21 levels underwent SA-OLIF and 21 patients with 26 levels underwent OLIF + LP. We compared clinical and radiographic outcomes between two groups. Clinical evaluation included Visual Analog Scale (VAS) for back pain and leg pain, Japanese Orthopaedic Association (JOA) scores and Oswestry Disability Index (ODI). Radiographical evaluation included disc height (DH), segmental lordosis angle (SL), and subsidence rate on standing lateral radiographs. Cage subsidence was classified using Marchi’s criteria. Results The mean follow-up duration was 6.3 ± 2.4 months. There were no significant differences among perioperative data (operation time, estimated intraoperative blood loss, and complication), clinical outcome (VAS, ODI, and JOA) and radiological outcome (SH and SL). The subsidence rate was 19.0% (4/21) in SA-OLIF group and 19.2% (5/26) in OLIF + LP group. 81.0% in SA-OLIF group and 80.8% in OLIF + LP group had Grade 0 subsidence, 14.3% in SA-OLIF group and 15.4% in OLIF + LP group had Grade I subsidence, and 4.8% in SA-OLIF group and 3.8% in OLIF + LP group had Grade II subsidence (P = 0.984). One patient with severe cage subsidence and lateral plate migration underwent revision surgery. Conclusions The additional lateral plate fixation does not appear to be more effective to prevent cage subsidence in the oblique lumbar interbody fusion, compared with stand-alone technique. If severe cage subsidence occurs, it may result in lateral plate migration in OLIF combined with lateral plate fixation.


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