Interdisciplinary Neurosurgery (Mar 2021)

Early experience with oblique lateral interbody fusion (OLIF) with posterior percutaneous screw placement (OLIFwPPS): Case series with clinical and radiographic outcomes

  • Christopher W. Rich,
  • Brandon Philbrick,
  • James G. Malcolm,
  • Daniel Refai,
  • Gerald E. Rodts, Jr.,
  • Matthew F. Gary

Journal volume & issue
Vol. 23
p. 100900

Abstract

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Background: Oblique Lateral Interbody Fusion (OLIF) is a relatively new approach which allows for access to the intervertebral disk space anterior to the psoas muscles, while remaining posterior to the more anterior vascular structures. Compared to posterior only fusion, OLIF results in reduced muscle dissection and preserved spinal anatomy, all while maximizing fusion surface area and providing indirect decompression. Methods: Thirteen patients treated by OLIF with percutaneous posterior screw placement since 2016 were retrospectively analyzed. Post-operative outcomes evaluated included fusion, adjacent segment degeneration, and pain scores. Spinopelvic parameters were analyzed pre and postoperatively. Results: The average number of vertebral levels treated was 2 (1–3), all between L2 and L5. Fusion was confirmed in all patients with an available CAT scan (7 of 7 patients). Adjacent segment degeneration was seen in 0 of the 13 patients. VAS showed an average improvement of 3.8 (2–8), with 11 out of 13 patients experiencing an improvement in pain. All 11 patients with multilevel fusions showed an improvement in pain. 8 of the 13 patients had mild degenerative scoliosis defined as a cobb angle >10°. All five of these patients showed improvement in postoperative pain scores. Conclusion: OLIF with percutaneous posterior screws can be considered a safe and effective treatment option for lumbar disk degeneration, with complication rates and improvement comparable to those seen with alternative approaches. Further studies are warranted to evaluate outcomes in larger samples with longer follow up data.

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