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Factors affecting successful immediate indirect decompression in oblique lateral interbody fusion in lumbar spinal stenosis patients – Lumbar Fusion

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The article discusses the use of oblique lumbar interbody fusion (OLIF) as a surgical technique for indirect decompression of spinal stenosis. The study aimed to identify the modifiable factors during surgery that contribute to successful radiological outcomes following OLIF surgery. The study included 46 patients who underwent OLIF without direct posterior decompression. The results showed that all radiological outcomes significantly improved postoperatively, including anterior and posterior disc heights, lumbar lordotic angle, foraminal height, and cross-sectional area of the thecal sac and foraminal area. The study found that the position of the cage in the middle of the vertebral body was associated with a greater improvement in foraminal height. Additionally, the restoration of posterior disc height was correlated with the improvement in cross-sectional foraminal area and foraminal height. Overall, OLIF was found to be an effective technique for indirect decompression in cases of central and foraminal spinal stenosis

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised spinal clinic in London

Published article

S: OLIF provided satisfactory immediate indirect decompression in central and foraminal spinal stenosis. Moreover, intraoperative surgical technique for successful radiologic CSF and FH improvement included restoration of the PDH and placement of the cage in the middle.

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N Am Spine Soc J. 2023 Sep 22;16:100279. doi: 10.1016/j.xnsj.2023.100279. eCollection 2023 Dec.ABSTRACTBACKGROUND: Oblique lumbar interbody fusion (OLIF) offers indirect decompression of stenotic lesions of the spinal canal and foramen through immediate disc height restoration. Only a few studies have reported the effect of cage position and associated intraoperatively modifiable factors for successful immediate indirect,

N Am Spine Soc J. 2023 Sep 22;16:100279. doi: 10.1016/j.xnsj.2023.100279. eCollection 2023 Dec.

ABSTRACT

BACKGROUND: Oblique lumbar interbody fusion (OLIF) offers indirect decompression of stenotic lesions of the spinal canal and foramen through immediate disc height restoration. Only a few studies have reported the effect of cage position and associated intraoperatively modifiable factors for successful immediate indirect decompression following OLIF surgery. This study aimed to investigate the intraoperatively modifiable factors for successful radiological outcomes of OLIF.

METHODS: This study included 46 patients with 80 surgical levels who underwent OLIF without direct posterior decompression. Preoperative and postoperative radiological parameters were evaluated and intraoperatively modifiable radiologic parameters for successful immediate radiologic decompression on magnetic resonance image (MRI) were determined. Radiologic parameters were preoperative and postoperative radiological parameters including anterior disc height (ADH), posterior disc height (PDH) lumbar lordotic angle (LLA), segmental lordotic angle (SLA), foraminal height (FH), cage position, cross-sectional area (CSA) of the thecal sac, cross-sectional foraminal area (CSF), facet distance (FD).

RESULTS: All radiologic outcomes significantly improved. Comparing preoperative and postoperative values, mean CSA increased from 99.63±40.21 mm2 to 125.02±45.90 mm2 (p<.0001), and mean left CSF increased from 44.54±12.90 mm2 to 69.91±10.80 mm2 (p<.0001). FD also increased from 1.40±0.44 to 1.92±0.71 mm (p<.0001). FH increased from 16.31±3.3 to 18.84±3.47 mm (p<.0001). ADH and PDH also significantly increased (p<.0001). Immediate postoperative CSF and FH improvement rate (%) were significantly correlated with posterior disc height restoration rate (%) (p=.0443, and p=.0234, respectively). In addition, the patients with a cage positioned in the middle of the vertebral body experienced a greater FH improvement rate (%) compared to the patients with a cage positioned anteriorly. Finally, Visual analogue scale (VAS) for leg pain was improved immediately.

S: OLIF provided satisfactory immediate indirect decompression in central and foraminal spinal stenosis. Moreover, intraoperative surgical technique for successful radiologic CSF and FH improvement included restoration of the PDH and placement of the cage in the middle.

PMID:37869545 | PMC:PMC10587750 | DOI:10.1016/j.xnsj.2023.100279

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Factors affecting successful immediate indirect decompression in oblique lateral interbody fusion in lumbar spinal stenosis patients

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N Am Spine Soc J. 2023 Sep 22;16:100279. doi: 10.1016/j.xnsj.2023.100279. eCollection 2023 Dec.ABSTRACTBACKGROUND: Oblique lumbar interbody fusion (OLIF) offers indirect decompression of stenotic lesions of the spinal canal and foramen through immediate disc height restoration. Only a few studies have reported the effect of cage position and associated intraoperatively modifiable factors for successful immediate indirect

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