Oblique lumbar interbody fusion for adjacent segment disease after posterior lumbar fusion: a case-controlled study
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(2019) 14:216
RESEARCH ARTICLE
Open Access
Oblique lumbar interbody fusion for adjacent segment disease after posterior lumbar fusion: a case-controlled study Cong Jin1, Minghua Xie1, Lei He1, Wenbin Xu2, Weiqi Han1, Wengqing Liang1 and Yu Qian1*
Abstract Background: This study assessed clinical and radiographic outcomes of oblique lumbar interbody fusion (OLIF) in comparison with posterior reoperation for adjacent segment disease (ASD). Methods: A total of 26 patients with symptomatic ASD after lumbar fusion were included in this retrospective case-controlled study conducted from January 2013 to December 2018. Twelve patients underwent single-segment OLIF with or without posterior instrumentation (OLIF group), whereas 14 patients underwent posterior reoperation (posterior approach group). The clinical outcomes included operative time, blood loss, hospital stay, Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and complications. Preoperative and postoperative radiographic outcomes were compared. Results: The operative time (60.6 ± 16.1 min vs. 150.9 ± 28.5 min, respectively; P < 0.05) and the blood loss in the OLIF group 89.2 ± 49.0 ml vs. 340.7 ± 130.2 ml, respectively; P < 0.05) were significantly lower than those in the posterior group. The hospital stay was lower in the OLIF group than in the posterior approach group (6.6 ± 1.3 days vs. 9.5 ± 2.5 days, respectively; P < 0.05). In the posterior approach group, 6 of 14 patients (42.8%) had issue with dural tear, while none in the OLIF group had such issue (P < 0.05). The ODI score (13.2 ± 4.2 vs. 19.2 ± 7.2, respectively; P = 0.014) and the VAS back pain score were lower in the OLIF group postoperatively and at last follow-up. In the OLIF group, the radiographic outcomes were significantly improved postoperatively. Conclusions: Due to our results and early experiences, we proposed that OLIF was safe and effective for ASD. Compared with posterior reoperation, OLIF results in shorter operative time and hospital stay, lesser blood loss, and lower risk of dural injury. Keywords: Oblique, Lumbar interbody fusion, Adjacent segment disease
Background Adjacent segment disease (ASD) is one of the most common complications of lumbar spine fusion [1]. Recently, spinal fusion has increasingly been used in the treatment of lumbar disorders with the development of surgical techniques and spinal instrumentation. In the USA, the annual incidence of spinal fusion has increased more than 600% during the last decade [2]. Spinal fusion techniques provide excellent clinical results for the treatment of various lumbar diseases; however, spinal fusion * Correspondence: [email protected] 1 Department of Orthopaedics, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Zhongxing North Road, Shaoxing 312000, Zhejiang, China Full list of author information is available at the end of the article
increases mechanical stress and segmental motion at adjacent segments, putting the patients at risk for developing ASD [3]. It has been repor
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