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Mini-Open Anterior Retroperitoneal Lumbar Interbody Fusion: Oblique Lateral Interbody Fusion for Degenerated Lumbar Spinal Kyphoscoliosis.

Ohtori S, Mannoji C, Orita S, Yamauchi K, Eguchi Y, Ochiai N, Kishida S, Kuniyoshi K, Aoki Y, Nakamura J, Ishikawa T, Miyagi M, Kamoda H, Suzuki M, Kubota G, Sakuma Y, Oikawa Y, Inage K, Sainoh T, Sato J, Shiga Y, Abe K, Fujimoto K, Kanamoto H, Toyone T, Inoue G, Takahashi K - Asian Spine J (2015)

Bottom Line: Pain scores significantly improved after surgery (p<0.05).Fusion rate was found to be 90%, balance parameters also improved after surgery (p<0.05), and average total blood loss was less than 350 mL.There was no spinal nerve, major vessel, peritoneal, or urinary injury, or breakage of instrumentation.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.

ABSTRACT

Study design: Prospective case series.

Purpose: To examine the clinical efficacy of mini-open anterior retroperitoneal lumbar interbody fusion: oblique lateral interbody fusion (OLIF) for degenerated lumbar spinal kyphoscoliosis.

Overview of literature: The existing surgical procedures for the treatment of spinal kyphotic deformity, including Smith-Petersen osteotomy, pedicle subtraction osteotomy, and vertebral column resection procedures, are invasive in nature. Extreme lateral interbody fusion to provide less invasive treatment of the deformity has been reported, but complications including spinal nerve and psoas muscle injury have been noted. In the current study, we examined the clinical efficacy and complications of OLIF for degenerated lumbar spinal kyphoscoliosis.

Methods: Twelve patients with degenerated lumbar spinal kyphoscoliosis were examined. All patients underwent OLIF surgery (using a cage and bone graft from the iliac crest) with open pedicle screws or percutaneous pedicle screws, without real-time monitoring by electromyography. Visual analog scale score and Oswestry disability index were evaluated before and 12 months after surgery, and fusion rate at OLIF cage, correction of the deformity, total blood loss, and surgical complications were also evaluated.

Results: Pain scores significantly improved after surgery (p<0.05). Fusion rate was found to be 90%, balance parameters also improved after surgery (p<0.05), and average total blood loss was less than 350 mL. There was no spinal nerve, major vessel, peritoneal, or urinary injury, or breakage of instrumentation.

Conclusions: OLIF surgery for degenerated lumbar spinal kyphoscoliosis is less invasive than other procedures and good surgical results were produced without major complications.

No MeSH data available.


Related in: MedlinePlus

(A) Skin marking to check the disk level using a C-arm X-ray imager. The skin incision was made 6 to 10 cm anterior to the midportion of the disk. A longitudinal incision from 3 to 4 cm is recommended. The surgeon cleared the peritoneum from the psoas using a finger. (B) Sequential dilation was used. (C) C-arm X-ray image after dilation. (D) Retractor for oblique lateral interbody fusion was used after dilatation. A trial cage was used after removal of the intervertebral disk. (E, F) A Clydesdale Spinal System cage filled with autologous bone is implanted. Implantation starts from a lateral oblique direction; finally the cage is inserted from a true lateral direction.
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Figure 2: (A) Skin marking to check the disk level using a C-arm X-ray imager. The skin incision was made 6 to 10 cm anterior to the midportion of the disk. A longitudinal incision from 3 to 4 cm is recommended. The surgeon cleared the peritoneum from the psoas using a finger. (B) Sequential dilation was used. (C) C-arm X-ray image after dilation. (D) Retractor for oblique lateral interbody fusion was used after dilatation. A trial cage was used after removal of the intervertebral disk. (E, F) A Clydesdale Spinal System cage filled with autologous bone is implanted. Implantation starts from a lateral oblique direction; finally the cage is inserted from a true lateral direction.

Mentions: All patients initially underwent OLIF (OLIF25) surgery. A cage (Clydesdale Spinal System) filled with bone graft from the iliac bone was used in this study (Figs. 1, 2). Subsequently, posterior fixation was employed in all patients. Open pedicle screws or percutaneous pedicle screws were used in all patients. Hooks and iliac screws were used in some patients. Open pedicle screws or percutaneous pedicle screws were used in all patients. Open pedicle screws were used for longer fusion, and percutaneous pedicle screws were used for relatively shorter fusion. Posterior osteotomy or posterior bone grafting was not performed in any patient. Rods were bent along the heads of the pedicle screws, and inserted into the heads of pedicle screws using reducers. Strong sagittal or rotational reduction was not performed in any patient. OLIF fusion from 1 to 4 levels and posterior fusion from 3 to 15 levels were performed. Posterior decompression was performed in one patient, but not in the others.


Mini-Open Anterior Retroperitoneal Lumbar Interbody Fusion: Oblique Lateral Interbody Fusion for Degenerated Lumbar Spinal Kyphoscoliosis.

Ohtori S, Mannoji C, Orita S, Yamauchi K, Eguchi Y, Ochiai N, Kishida S, Kuniyoshi K, Aoki Y, Nakamura J, Ishikawa T, Miyagi M, Kamoda H, Suzuki M, Kubota G, Sakuma Y, Oikawa Y, Inage K, Sainoh T, Sato J, Shiga Y, Abe K, Fujimoto K, Kanamoto H, Toyone T, Inoue G, Takahashi K - Asian Spine J (2015)

(A) Skin marking to check the disk level using a C-arm X-ray imager. The skin incision was made 6 to 10 cm anterior to the midportion of the disk. A longitudinal incision from 3 to 4 cm is recommended. The surgeon cleared the peritoneum from the psoas using a finger. (B) Sequential dilation was used. (C) C-arm X-ray image after dilation. (D) Retractor for oblique lateral interbody fusion was used after dilatation. A trial cage was used after removal of the intervertebral disk. (E, F) A Clydesdale Spinal System cage filled with autologous bone is implanted. Implantation starts from a lateral oblique direction; finally the cage is inserted from a true lateral direction.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4522447&req=5

Figure 2: (A) Skin marking to check the disk level using a C-arm X-ray imager. The skin incision was made 6 to 10 cm anterior to the midportion of the disk. A longitudinal incision from 3 to 4 cm is recommended. The surgeon cleared the peritoneum from the psoas using a finger. (B) Sequential dilation was used. (C) C-arm X-ray image after dilation. (D) Retractor for oblique lateral interbody fusion was used after dilatation. A trial cage was used after removal of the intervertebral disk. (E, F) A Clydesdale Spinal System cage filled with autologous bone is implanted. Implantation starts from a lateral oblique direction; finally the cage is inserted from a true lateral direction.
Mentions: All patients initially underwent OLIF (OLIF25) surgery. A cage (Clydesdale Spinal System) filled with bone graft from the iliac bone was used in this study (Figs. 1, 2). Subsequently, posterior fixation was employed in all patients. Open pedicle screws or percutaneous pedicle screws were used in all patients. Hooks and iliac screws were used in some patients. Open pedicle screws or percutaneous pedicle screws were used in all patients. Open pedicle screws were used for longer fusion, and percutaneous pedicle screws were used for relatively shorter fusion. Posterior osteotomy or posterior bone grafting was not performed in any patient. Rods were bent along the heads of the pedicle screws, and inserted into the heads of pedicle screws using reducers. Strong sagittal or rotational reduction was not performed in any patient. OLIF fusion from 1 to 4 levels and posterior fusion from 3 to 15 levels were performed. Posterior decompression was performed in one patient, but not in the others.

Bottom Line: Pain scores significantly improved after surgery (p<0.05).Fusion rate was found to be 90%, balance parameters also improved after surgery (p<0.05), and average total blood loss was less than 350 mL.There was no spinal nerve, major vessel, peritoneal, or urinary injury, or breakage of instrumentation.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.

ABSTRACT

Study design: Prospective case series.

Purpose: To examine the clinical efficacy of mini-open anterior retroperitoneal lumbar interbody fusion: oblique lateral interbody fusion (OLIF) for degenerated lumbar spinal kyphoscoliosis.

Overview of literature: The existing surgical procedures for the treatment of spinal kyphotic deformity, including Smith-Petersen osteotomy, pedicle subtraction osteotomy, and vertebral column resection procedures, are invasive in nature. Extreme lateral interbody fusion to provide less invasive treatment of the deformity has been reported, but complications including spinal nerve and psoas muscle injury have been noted. In the current study, we examined the clinical efficacy and complications of OLIF for degenerated lumbar spinal kyphoscoliosis.

Methods: Twelve patients with degenerated lumbar spinal kyphoscoliosis were examined. All patients underwent OLIF surgery (using a cage and bone graft from the iliac crest) with open pedicle screws or percutaneous pedicle screws, without real-time monitoring by electromyography. Visual analog scale score and Oswestry disability index were evaluated before and 12 months after surgery, and fusion rate at OLIF cage, correction of the deformity, total blood loss, and surgical complications were also evaluated.

Results: Pain scores significantly improved after surgery (p<0.05). Fusion rate was found to be 90%, balance parameters also improved after surgery (p<0.05), and average total blood loss was less than 350 mL. There was no spinal nerve, major vessel, peritoneal, or urinary injury, or breakage of instrumentation.

Conclusions: OLIF surgery for degenerated lumbar spinal kyphoscoliosis is less invasive than other procedures and good surgical results were produced without major complications.

No MeSH data available.


Related in: MedlinePlus