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Miniopen oblique lateral L5-s1 interbody fusion: a report of 2 cases.

Kanno K, Ohtori S, Orita S, Yamauchi K, Eguchi Y, Aoki Y, Nakamura J, Miyagi M, Suzuki M, Kubota G, Inage K, Sainoh T, Sato J, Shiga Y, Abe K, Fujimoto K, Kanamoto H, Toyone T, Inoue G, Hanaoka E, Takahashi K - Case Rep Orthop (2014)

Bottom Line: Pain scores significantly improved after surgery.There was no spinal nerve, major vessel, peritoneal, or urinary injury.OLIF surgery was minimally invasive and produced good surgical results without complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.

ABSTRACT
Extreme lateral interbody fusion (XLIF) has been widely used for minimally invasive anterior lumbar interbody fusion (ALIF), but an approach to L5-S1 is difficult because of the iliac crest. In the current study, we present 2 cases using minimally invasive oblique lateral interbody fusion (OLIF) of L5-S1. The patients showed foraminal stenosis between L5 and S1 and severe low back and leg pain. The patients were placed in a lateral decubitus position and underwent OLIF surgery (using a cage and bone graft from the iliac crest) without posterior decompression. Posterior screws were used in the patients. Pain scores significantly improved after surgery. There was no spinal nerve, major vessel, peritoneal, or urinary injury. OLIF surgery was minimally invasive and produced good surgical results without complications.

No MeSH data available.


Related in: MedlinePlus

((a) and (b)) Dilators were used at first, and, next, retractors with light were used. (c) Removed cage. (d) Insertion of the SynCage.
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fig2: ((a) and (b)) Dilators were used at first, and, next, retractors with light were used. (c) Removed cage. (d) Insertion of the SynCage.

Mentions: A 68-year-old man presented with a 15-month history of right sciatica with complaints of pain in his buttocks and the lateral aspect of his right leg corresponding to the L5 dermatome. We performed TLIF with instrumentation at L5-S1. The patient became symptom-free immediately after surgery. However, 6 months later, the cage had moved posteriorly (Figure 1(a)). The patient showed severe leg pain corresponding to the right L5 spinal nerve. MRI revealed right foraminal stenosis between L5 and S1 because of the cage. We performed OLIF with the patient in a lateral decubitus position. A 5 cm skin incision was made 10 cm anterior from the midportion of the L5-S1 disk on the left side, and the retroperitoneal space was accessed (Figure 1(b)). The L5-S1 disk was accessed using an OLIF device between the major vessels (Figures 1(c), 2(a), and 2(b)). First, dilators were used, and then retractors with light were used (Figures 2(a) and 2(b)). The TLIF cage was removed and we inserted a SynCage (Synthes, Inc., PA, USA) filled with bone graft harvested from the iliac crest (Figures 2(c) and 2(d)). We used additional percutaneous pedicle screws. X-ray image examination showed good stability and disk height (Figure 3). On a follow-up examination, the patient was symptom-free.


Miniopen oblique lateral L5-s1 interbody fusion: a report of 2 cases.

Kanno K, Ohtori S, Orita S, Yamauchi K, Eguchi Y, Aoki Y, Nakamura J, Miyagi M, Suzuki M, Kubota G, Inage K, Sainoh T, Sato J, Shiga Y, Abe K, Fujimoto K, Kanamoto H, Toyone T, Inoue G, Hanaoka E, Takahashi K - Case Rep Orthop (2014)

((a) and (b)) Dilators were used at first, and, next, retractors with light were used. (c) Removed cage. (d) Insertion of the SynCage.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4221972&req=5

fig2: ((a) and (b)) Dilators were used at first, and, next, retractors with light were used. (c) Removed cage. (d) Insertion of the SynCage.
Mentions: A 68-year-old man presented with a 15-month history of right sciatica with complaints of pain in his buttocks and the lateral aspect of his right leg corresponding to the L5 dermatome. We performed TLIF with instrumentation at L5-S1. The patient became symptom-free immediately after surgery. However, 6 months later, the cage had moved posteriorly (Figure 1(a)). The patient showed severe leg pain corresponding to the right L5 spinal nerve. MRI revealed right foraminal stenosis between L5 and S1 because of the cage. We performed OLIF with the patient in a lateral decubitus position. A 5 cm skin incision was made 10 cm anterior from the midportion of the L5-S1 disk on the left side, and the retroperitoneal space was accessed (Figure 1(b)). The L5-S1 disk was accessed using an OLIF device between the major vessels (Figures 1(c), 2(a), and 2(b)). First, dilators were used, and then retractors with light were used (Figures 2(a) and 2(b)). The TLIF cage was removed and we inserted a SynCage (Synthes, Inc., PA, USA) filled with bone graft harvested from the iliac crest (Figures 2(c) and 2(d)). We used additional percutaneous pedicle screws. X-ray image examination showed good stability and disk height (Figure 3). On a follow-up examination, the patient was symptom-free.

Bottom Line: Pain scores significantly improved after surgery.There was no spinal nerve, major vessel, peritoneal, or urinary injury.OLIF surgery was minimally invasive and produced good surgical results without complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.

ABSTRACT
Extreme lateral interbody fusion (XLIF) has been widely used for minimally invasive anterior lumbar interbody fusion (ALIF), but an approach to L5-S1 is difficult because of the iliac crest. In the current study, we present 2 cases using minimally invasive oblique lateral interbody fusion (OLIF) of L5-S1. The patients showed foraminal stenosis between L5 and S1 and severe low back and leg pain. The patients were placed in a lateral decubitus position and underwent OLIF surgery (using a cage and bone graft from the iliac crest) without posterior decompression. Posterior screws were used in the patients. Pain scores significantly improved after surgery. There was no spinal nerve, major vessel, peritoneal, or urinary injury. OLIF surgery was minimally invasive and produced good surgical results without complications.

No MeSH data available.


Related in: MedlinePlus