Application of Stand-Alone Oblique Lateral Interbody Fusion in L4-5 Lumbar Diseases

Summary

This study describes the application of oblique lateral interbody fusion in lumbar spinal surgeries.

Abstract

Lumbar spine diseases often cause lower back pain, lower extremity pain, numbness, and paresthesia. In severe cases, intermittent claudication may occur, affecting the quality of life of patients. Surgery is often required when conservative treatment fails, or when patients' symptoms become unbearable. Surgical treatments include laminectomy and discectomy, as well as interbody fusion. The main purpose of laminectomy and discectomy is to relieve nerve compression; however, recurrence is common due to spinal instability. Interbody fusion improves stability while relieving nerve compression and significantly reduces the risk of recurrence compared to non-fusion surgery. Nonetheless, conventionally posterior intervertebral fusion requires separation of the muscles to expose the operated segment, which causes more trauma to the patient. In contrast, the oblique lateral interbody fusion (OLIF) technique achieves spinal fusion with minimal trauma to the patients and shortens the recovery time. This article introduces procedures of stand-alone OLIF surgery performed in the lumbar spine, providing a reference for other spine surgeons.

Introduction

Lumbar spine disorders are a global economic concern, with affected patients experiencing lower quality of life¹. The treatment of lumbar spine diseases can be divided into two categories: conservative and surgical treatment. Conservative treatment includes rest, oral nonsteroidal drugs, massage, and physical therapy. For instance, studies have shown that estrogen can be used to delay degeneration of the intervertebral disc, thus providing a basis for its treatment of lumbar spine disease^2,3. For patients who have failed in conservative treatment, surgery is typically required to treat ....

Protocol

This study has been approved by the Ethics Committee of the Third Hospital of Hebei Medical University. The patients signed informed consent, consented to be filmed, and allowed the investigators to use their surgical data.

1. Patient selection

1. Select patients based on the following inclusion criteria.
   1. Select patients for whom conservative treatment time was longer than 3 months and to which the patients responded poorly.
   2. Select patients whose symptoms and signs were consistent with the imaging findings.
   3. Select patients whose magnetic resonance imaging (MRI) of the lumbar spine ....

Results

Studies from other groups have shown that, compared to other methods, OLIF surgery has the advantages of a shorter operative time and less intraoperative blood loss (Table 1). Importantly, patients who undergo OLIF surgery recover faster than the commonly used TLIF surgery group^12,21,22. Our research group has monitored 42 patients with degenerative lumbar spondylolisthesis (DLS) undergoing OLIF surgery for more.......

Discussion

Since formally introduced by Silvestre in 2012²³, OLIF has gradually attracted the attention of spine surgeons due to the various advantages over other methods used in treating lumbar spine diseases^{6,12,13,16,21,22}. OLIF significantly improved patients' disc height and lordotic angle, which may be due .......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Bipolar electrocoagulation tweezers	Juan'en Medical Devices Co.Ltd	BZN-Q-B-S	1.2 x 190 mm
Bone rasp	DePuy Synthes	03.809.849	35 x 8 mm
Cefazolin	Cspc Pharmaceutical Group Limited		1.0 g
Computed Tomography	PHILIPS
Curette	Qingniu	20739.01	300 x Ø9 x 5°
Curette	DePuy Synthes	03.809.873	6 mm
Dilation tubes	DePuy Synthes	03.809.913	140 mm
High frequency active electrodes	ZhongBangTianCheng	GD-BZ	GD-BZ-J1
Interbody cage	DePuy Synthes	08.809.273S	55 x 22 x 13 mm
Intervertebral exploration device	DePuy Synthes	03.809.233	13 mm
Kirschner wire	Qingniu
Lighting cable	DePuy Synthes	03.612.031
Lighting sheet	DePuy Synthes	03.809.925S
Low Molecular Weight Heparin Sodium Injection	Cspc Pharmaceutical Group Limited		0.4 mL
MRI	PHILIPS
Scraper	DePuy Synthes	03.809.833	13 mm
Spreader	DePuy Synthes	03.809.877	50 x 13 mm
Surgical film	3L	SP4530	45 x 30 cm
Ultrasound Color Doppler	PHILIPS
Universal arm	DePuy Synthes	03.809.941
Universal arm operating table clips	DePuy Synthes	03.809.942
X-ray machine	GE healthcare