scholarly journals Oblique Lateral Interbody Fusion versus Transforaminal Lumbar Interbody Fusion in Degenerative Lumbar Spondylolisthesis: A Single-Center Retrospective Comparative Study

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Xing Du ◽  
Yuxiao She ◽  
Yunsheng Ou ◽  
Yong Zhu ◽  
Wei Luo ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Operation Time ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Single Level ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Objective. To compare the efficacy of oblique lateral interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF) in single-level degenerative lumbar spondylolisthesis (DLS). Methods. A retrospective analysis of patients who underwent single-level DLS surgery in our department from 2015 to 2018 was performed. According to the surgical method, the enrolled patients were divided into two groups, namely, the OLIF group who underwent OLIF combined with percutaneous pedicle screw fixation (PPSF) and the TLIF group. Clinical outcomes included operation time, operation blood loss, postoperative drainage, hospital stay, visual analog scale (VAS) score, Oswestry disability index (ODI), and complications, and imaging outcomes included upper vertebral slip, intervertebral space height (ISH), intervertebral foramen height (IFH), intervertebral space angle (ISA), lumbar lordosis (LL), and bone fusion rate. All outcomes were recorded and analyzed. Results. A total of 65 patients were finally included, and there were 28 patients and 37 patients in the OLIF group and the TLIF group, respectively. The OLIF group showed shorter operation time, less blood loss, less postoperative drainage, and shorter hospital stay than the TLIF group ( P < 0.05 ). The ISH, IFH, ISA, and LL were all larger in the OLIF group at postoperative and last follow-up ( P < 0.05 ), but the degree of upper vertebral slip was found no difference between the two groups ( P > 0.05 ). The bone graft fusion rate of OLIF group and TLIF group at 3 months, 6 months, and last follow-up was 78.57%, 92.86%, and 100% and 70.27%, 86.49%, and 97.30%, respectively, and no significant differences were found ( P > 0.05 ). Compared with the TLIF group, the OLIF group showed a superior improvement in VAS and ODI at 1 month, 3 months, and 6 months postoperative ( P < 0.05 ), but no differences were found at 12 months postoperative and the last follow-up ( P > 0.05 ). There was no significant difference in complications between the two groups, with 4 patients and 6 patients in the OLIF group and TLIF group, respectively ( P > 0.05 ). Conclusions. Compared with TLIF, OLIF showed the advantages of less surgical invasion, better decompression effect, and faster postoperative recovery in single-level DLS surgery.

scholarly journals Oblique Lumbar Interbody Fusion with Stand-Alone Cages for the Treatment of Degenerative Lumbar Spondylolisthesis: A Retrospective Study with 1-Year Follow-Up

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Yachong Huo ◽  
Dalong Yang ◽  
Lei Ma ◽  
Haidong Wang ◽  
Wenyuan Ding ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Disc Height ◽  
Degenerative Lumbar Spondylolisthesis ◽  
The Mean ◽  
One Year ◽  
Psoas Major ◽  
Lumbar Spondylolisthesis ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Patients with degenerative lumbar spondylolisthesis (DLS) often suffer from years of low back pain (LBP) due to instability of the lumbar spine and the reduction of disc height. Since January 2016, we have performed oblique lateral interbody fusion (OLIF) on 154 patients. Among these, 56 patients who suffered from DLS underwent OLIF with stand-alone cages. Forty-two patients with a follow-up time that exceeded 1-year were enrolled for this study. The forty-two patients were followed up for at least one year. Operation segments ranged from L3-4 to L4-5. All the patients were with 1-level fusion. The mean postoperative ventral-disc height and dorsal-disc height increased significantly compared with preoperative (P<0.05). A significant postoperative increase was also observed in the mean operative segmental lordotic angle and the whole lumbar lordotic angle (P<0.05). Compared with preoperative, the postoperative VAS significantly decreased with no significant increase in the VAS in the last follow-up. The LBP was significantly relieved. The mean postoperative VAS of LBP decreased significantly compared with the preoperative ((1.6 ± 0.8) vs. (7.8 ± 0.8)). Postoperative complications included psoas major abscess and intervertebral space infection (1/56). Except for one patient whose cage subsided during the last follow-up, the other patients had good cage position. The one whose cage collapsed complained no symptoms including LBP. OLIF with stand-alone cages should be considered as a safe and effective option which can effectively alleviate LBP for the treatment of DLS.

Obesity may be associated with adjacent-segment degeneration after single-level transforaminal lumbar interbody fusion in spinopelvic-mismatched patients with a minimum 2-year follow-up

2021 ◽  
Vol 34 (1) ◽  
pp. 83-88
Author(s):  
Ping-Guo Duan ◽  
Praveen V. Mummaneni ◽  
Minghao Wang ◽  
Andrew K. Chan ◽  
Bo Li ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Adjacent Segment Degeneration ◽  
Adjacent Segment ◽  
Lumbar Interbody Fusion ◽  
Inclusion Criteria ◽  
Single Level ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Surgery Rates

OBJECTIVEIn this study, the authors’ aim was to investigate whether obesity affects surgery rates for adjacent-segment degeneration (ASD) after transforaminal lumbar interbody fusion (TLIF) for spondylolisthesis.METHODSPatients who underwent single-level TLIF for spondylolisthesis at the University of California, San Francisco, from 2006 to 2016 were retrospectively analyzed. Inclusion criteria were a minimum 2-year follow-up, single-level TLIF, and degenerative lumbar spondylolisthesis. Exclusion criteria were trauma, tumor, infection, multilevel fusions, non-TLIF fusions, or less than a 2-year follow-up. Patient demographic data were collected, and an analysis of spinopelvic parameters was performed. The patients were divided into two groups: mismatched, or pelvic incidence (PI) minus lumbar lordosis (LL) ≥ 10°; and balanced, or PI-LL < 10°. Within the two groups, the patients were further classified by BMI (< 30 and ≥ 30 kg/m2). Patients were then evaluated for surgery for ASD, matched by BMI and PI-LL parameters.RESULTSA total of 190 patients met inclusion criteria (72 males and 118 females, mean age 59.57 ± 12.39 years). The average follow-up was 40.21 ± 20.42 months (range 24–135 months). In total, 24 patients (12.63% of 190) underwent surgery for ASD. Within the entire cohort, 82 patients were in the mismatched group, and 108 patients were in the balanced group. Within the mismatched group, adjacent-segment surgeries occurred at the following rates: BMI < 30 kg/m2, 2.1% (1/48); and BMI ≥ 30 kg/m2, 17.6% (6/34). Significant differences were seen between patients with BMI ≥ 30 and BMI < 30 (p = 0.018). A receiver operating characteristic curve for BMI as a predictor for ASD was established, with an AUC of 0.69 (95% CI 0.49–0.90). The optimal BMI cutoff value determined by the Youden index is 29.95 (sensitivity 0.857; specificity 0.627). However, in the balanced PI-LL group (108/190 patients), there was no difference in surgery rates for ASD among the patients with different BMIs (p > 0.05).CONCLUSIONSIn patients who have a PI-LL mismatch, obesity may be associated with an increased risk of surgery for ASD after TLIF, but in obese patients without PI-LL mismatch, this association was not observed.

scholarly journals A Comparison of Minimally Invasive Transforaminal Lumbar Interbody Fusion and Decompression Alone for Degenerative Lumbar Spondylolisthesis

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Andrew Kai-Hong Chan ◽  
Erica F Bisson ◽  
Mohamad Bydon ◽  
Steven D Glassman ◽  
Kevin T Foley ◽  
...  
Keyword(s):  
Back Pain ◽  
Minimally Invasive ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Reoperation Rate ◽  
Leg Pain ◽  
Lumbar Interbody Fusion ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis

Abstract INTRODUCTION The optimal minimally invasive surgical (MIS) approach for lumbar spondylolisthesis is not clearly elucidated. This study compares patient reported outcomes (PRO) following MIS transforaminal lumbar interbody fusion (MI-TLIF) and MIS decompression for degenerative lumbar spondylolisthesis. METHODS A total of 608 patients from the Quality Outcomes Database (QOD) Lumbar Spondylolisthesis Module underwent single-level surgery for degenerative grade 1 lumbar spondylolisthesis of whom 143 underwent MIS [72 MI-TLIF (50.3%) and 71 MIS decompressions (49.7%)]. Surgeries were classified as MIS if there was utilization of percutaneous screw fixation and placement of a Wiltse-plane MIS intervertebral body graft (MI-TLIF) or if there was a tubular decompression (MIS decompression). In total, 24-mo follow-up parameters were collected. PROs included the Oswestry Disability Index (ODI), numeric rating scale (NRS) Back Pain, NRS Leg Pain, EuroQoL-5D (EQ-5D) Questionnaire, and North American Spine Society (NASS) Satisfaction Questionnaire. Multivariate models were constructed adjusting for baseline patient and surgical factors. RESULTS The mean age of the MIS cohort was 67.1 ± 11.3 yr (MI-TLIF 62.1 yr vs MIS decompression 72.3 yr) and consisted of 79 (55.2%) women (MI-TLIF 55.6% vs MIS decompression 54.9%). The proportions reaching 24-mo follow-up were similar (MI-TLIF 83.3% and MIS decompression 84.5%; P = .85). MI-TLIF was associated with higher blood loss (108.8 vs 33.0 mL, P < .001), longer operative times (228.2 vs 101.8 min, P < .001) and length of hospitalization (2.9 vs 0.7 d, P < .001). MI-TLIF was associated with a significantly lower reoperation rate (14.1% vs 1.4%, P = .004). Both cohorts demonstrated significant improvements in ODI, NRS back pain, NRS leg pain, and EQ-5D at 24 mo (P < .001). In multivariate analyses, MI-TLIF was associated with superior ODI change (ß = −7.59; 95% CI [−14.96 to −0.23]; P = .04), NRS back pain change (ß = −1.54; 95% CI [−2.78 to −0.30]; P = .02), and NASS satisfaction (OR = 0.32; 95% CI [0.12-0.82]; P = .02). CONCLUSION For symptomatic, single-level degenerative spondylolisthesis, MI-TLIF was associated with a 10-fold lower reoperation rate and superior outcomes for disability, back pain, and patient satisfaction compared to MIS decompression alone.

scholarly journals Comparison of Clinical and Radiologic Results of Mini-Open Transforaminal Lumbar Interbody Fusion and Extreme Lateral Interbody Fusion Indirect Decompression for Degenerative Lumbar Spondylolisthesis

2018 ◽  
Vol 12 (2) ◽  
pp. 356-364 ◽  
Author(s):  
Yutaka Kono ◽  
Hogaku Gen ◽  
Yoshio Sakuma ◽  
Yasuhide Koshika
Keyword(s):  
Blood Loss ◽  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Hospitalization Period ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Indirect Decompression ◽  
Lumbar Spondylolisthesis ◽  
Lateral Interbody ◽  
Mini Open

<sec><title>Study Design</title><p>Retrospective study.</p></sec><sec><title>Purpose</title><p>In this study, we compared the postoperative outcomes of extreme lateral interbody fusion (XLIF) indirect decompression with that of mini-open transforaminal lumbar interbody fusion (TLIF) in patients with lumbar degenerative spondylolisthesis.</p></sec><sec><title>Overview of Literature</title><p>There are very few reports examining postoperative results of XLIF and minimally invasive TLIF for degenerative lumbar spondylolisthesis, and no reports comparing XLIF and mini-open TLIF.</p></sec><sec><title>Methods</title><p>Forty patients who underwent 1-level spinal fusion, either by XLIF indirect decompression (X group, 20 patients) or by mini-open TLIF (T group, 20 patients), for treatment of lumbar degenerative spondylolisthesis were included in this study. Invasiveness of surgery was evaluated on the basis of surgery time, blood loss, hospitalization period, and perioperative complications. The Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ), disc angle (DA), disc height (DH), and slipping length (SL) were evaluated before surgery, immediately after surgery, and at 12 months after surgery. Cross-sectional spinal canal area (CSA) was also measured before surgery and at 1 month after surgery.</p></sec><sec><title>Results</title><p>There was no significant difference between the groups in terms of surgery time or hospitalization period; however, X group showed a significant decrease in blood loss (<italic>p</italic>&lt;0.001). Serious complications were not observed in either group. In clinical assessment, no significant differences were observed between the groups with regard to the JOABPEQ results. The change in DH at 12 months after surgery increased significantly in the X group (<italic>p</italic>&lt;0.05), and the changes in DA and SL were not significantly different between the two groups. The change in CSA was significantly greater in the T group (<italic>p</italic>&lt;0.001).</p></sec><sec><title>Conclusions</title><p>Postoperative clinical results were equally favorable for both procedures; however, in comparison with mini-open TLIF, less blood loss and greater correction of DH were observed in XLIF.</p></sec>

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

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.

scholarly journals A comparison of minimally invasive transforaminal lumbar interbody fusion and decompression alone for degenerative lumbar spondylolisthesis

2019 ◽  
Vol 46 (5) ◽  
pp. E13 ◽  
Author(s):  
Andrew K. Chan ◽  
Erica F. Bisson ◽  
Mohamad Bydon ◽  
Steven D. Glassman ◽  
Kevin T. Foley ◽  
...  
Keyword(s):  
Back Pain ◽  
Minimally Invasive ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Reoperation Rate ◽  
Leg Pain ◽  
Lumbar Interbody Fusion ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis

OBJECTIVEThe optimal minimally invasive surgery (MIS) approach for grade 1 lumbar spondylolisthesis is not clearly elucidated. In this study, the authors compared the 24-month patient-reported outcomes (PROs) after MIS transforaminal lumbar interbody fusion (TLIF) and MIS decompression for degenerative lumbar spondylolisthesis.METHODSA total of 608 patients from 12 high-enrolling sites participating in the Quality Outcomes Database (QOD) lumbar spondylolisthesis module underwent single-level surgery for degenerative grade 1 lumbar spondylolisthesis, of whom 143 underwent MIS (72 MIS TLIF [50.3%] and 71 MIS decompression [49.7%]). Surgeries were classified as MIS if there was utilization of percutaneous screw fixation and placement of a Wiltse plane MIS intervertebral body graft (MIS TLIF) or if there was a tubular decompression (MIS decompression). Parameters obtained at baseline through at least 24 months of follow-up were collected. PROs included the Oswestry Disability Index (ODI), numeric rating scale (NRS) for back pain, NRS for leg pain, EuroQol-5D (EQ-5D) questionnaire, and North American Spine Society (NASS) satisfaction questionnaire. Multivariate models were constructed to adjust for patient characteristics, surgical variables, and baseline PRO values.RESULTSThe mean age of the MIS cohort was 67.1 ± 11.3 years (MIS TLIF 62.1 years vs MIS decompression 72.3 years) and consisted of 79 (55.2%) women (MIS TLIF 55.6% vs MIS decompression 54.9%). The proportion in each cohort reaching the 24-month follow-up did not differ significantly between the cohorts (MIS TLIF 83.3% and MIS decompression 84.5%, p = 0.85). MIS TLIF was associated with greater blood loss (mean 108.8 vs 33.0 ml, p < 0.001), longer operative time (mean 228.2 vs 101.8 minutes, p < 0.001), and longer length of hospitalization (mean 2.9 vs 0.7 days, p < 0.001). MIS TLIF was associated with a significantly lower reoperation rate (14.1% vs 1.4%, p = 0.004). Both cohorts demonstrated significant improvements in ODI, NRS back pain, NRS leg pain, and EQ-5D at 24 months (p < 0.001, all comparisons relative to baseline). In multivariate analyses, MIS TLIF—as opposed to MIS decompression alone—was associated with superior ODI change (β = −7.59, 95% CI −14.96 to −0.23; p = 0.04), NRS back pain change (β = −1.54, 95% CI −2.78 to −0.30; p = 0.02), and NASS satisfaction (OR 0.32, 95% CI 0.12–0.82; p = 0.02).CONCLUSIONSFor symptomatic, single-level degenerative spondylolisthesis, MIS TLIF was associated with a lower reoperation rate and superior outcomes for disability, back pain, and patient satisfaction compared with posterior MIS decompression alone. This finding may aid surgical decision-making when considering MIS for degenerative lumbar spondylolisthesis.

scholarly journals Endoscopic transforaminal lumbar interbody fusion in the treatment of degenerative lumbar spondylolisthesis

2019 ◽  
Author(s):  
Denglu Yan ◽  
Zaiheng Zhang ◽  
Zhi Zhang
Keyword(s):  
Interbody Fusion ◽  
Reduction Rate ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Intervertebral Foramen ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis ◽  
Disk Height ◽  
Endoscopic Group

Abstract Background There were no studies in literature of lumbar spondylolisthesis treated by endoscopic surgery. The purpose of this study was to evaluate the efficacy of endoscopic transforaminal lumbar interbody fusion (ELIF) in the treatment of degenerative lumbar spondylolisthesis by compare to the standard transforaminal lumbar interbody fusion (TLIF).Methods A total of 93 patients with lumbar spondylolisthesis who had surgery from February 2017 to January 2018 were categorized into different groups depending on the procedure by ELIF or TLIF. The ELIF and TLIF procedures was performed, and the clinical outcomes of blood loss, operation times, hospital stay days, pain index, ODI score, the spondylolisthesis rate and reduction rate, and the disk height and intervertebral foramen height were recorded.Results There was no intraoperative death in this series. In ends 86 cases had follow-up at least one year and 7 cases lost, and the follow-up rate and followed time were no difference between two groups (P > 0.05). The operational time was longer in ELIF than TLIF (P < 0.01).The hospital days and blood loss were significant less in endoscopic group than TLIF (P < 0.01). The pain index and ODI score, the spondylolisthesis rate and reduction rate, and the disk height and intervertebral foramen height were better than preoperational (P < 0.01), and there were no difference between two groups (P > 0.05). All patients achieved spinal fusion with no cases of cage extrusion, and no infection, and no dural tear of cerebrospinal fluid leakage complication. There were one case of radiculitis (man) at endoscopic group. CT-myelogram revealed the radiculitis patients had normal radiologic findings, and the patient was recovered by neurotrophy drugs and functional exercises after 3 months.Conclusions Endoscopic lumbar decompression and interbody fusion procedures was effective and safe measure in the treatment of the lumbar spondylolisthesis. Compare to open interbody fusion techniques, endoscopic lumbar interbody fusion was minimally invasive surgery with less bold loss and earlier postoperative recovery.

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