Journal
FRONTIERS IN SURGERY
Volume 10, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fsurg.2023.1130489
Keywords
oblique lumbar interbody fusion; psoas; direct microscopic vision; nerve injury; vascular injury
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This is a retrospective study that demonstrates a modified oblique lumbar interbody fusion technique. The modified technique allows for easy exposure of the lumbar spine under direct microscopic vision, resulting in less psoas weakness and neurovascular injury.
Study designThis is a retrospective study.ObjectiveTo demonstrate a modified oblique lumbar interbody fusion (OILF) technique for L1-L5.MethodsThe modified technique splits anterior portion of psoas belly to access the oblique corridor (OC) anteroinferior to psoas, minimizing psoas manipulation and retraction and avoiding nerve injury while offering excellent microscopic visualization. Psoas weakness and neurovascular complication rates in patients treated with traditional OLIF (T-OLIF) or anteroinferior psoas OLIF (AP-OLIF) were retrospectively reviewed. Clinical outcomes were also reviewed.ResultsA total of 162 cases treated with T-OLIF (n = 73) and AP-OLIF (n = 89) for degenerative lumbar disease were included. The mean operative time and blood loss were less with AP-OLIF (P < 0.01). Approach related complications were 14 (19.1%) with T-OLIF and 4 (4.5%) with AP-OLIF. Postoperative visual analog scale (VAS) and Oswestry Disability Index (ODI) scores improved in both T-OIF and AP-OIF groups (P < 0.01).ConclusionThe modified OLIF technique (AP-OLIF) is characterized by an easy exposure of the lumbar spine under direct microscopic vision, resulting in less psoas weakness and neurovascular injury.
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