Oblique Lumbar Interbody Fusion: Technical Aspects, Operative Outcomes, and Complications

被引:144
作者
Li, Jia Xi Julian [1 ,2 ]
Phan, Kevin [1 ,3 ]
Mobbs, Ralph [1 ,2 ]
机构
[1] Prince Wales Private Hosp, NeuroSpine Clin, NeuroSpine Surg Res Grp NSURG, Randwick, NSW, Australia
[2] Univ New South Wales UNSW, Fac Med, Sydney, NSW, Australia
[3] Univ Sydney, Fac Med, Sydney, NSW, Australia
关键词
Anterior-to-psoas; Lumbar interbody fusion; Oblique lumbar interbody fusion; MINI-OPEN; ANTEROLATERAL APPROACH; SURGERY; SPINE; DISEASE; ACCESS;
D O I
10.1016/j.wneu.2016.10.074
中图分类号
R74 [神经病学与精神病学];
学科分类号
100204 [神经病学];
摘要
OBJECTIVE: Anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF) are commonly used approaches for lumbar spine fusion surgery, each with their own unique advantages and disadvantages. ALIF requires mobilization of the great vessels and peritoneum, and dissection of the psoas muscle in the LLIF technique is associated with postoperative neurologic complications in the proximal lower limb. The anterior-to-psoas (ATP) or oblique lumbar interbody fusion (OLIF) technique is the proposed solution to accessing the L1-L5 levels without the issues encountered with ALIF and LLIF. In this review, the technical nuances, operative outcomes, and complications with the ATP/OLIF technique in the current literature are summarized. METHODS: A systematic search of the literature was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Data collected included operative time, blood loss, postoperative hospital stay, and complications, which were then pooled together. RESULTS: From the 16 studies selected, the mean blood loss was 109.9 mL, average operating time was 95.2 minutes, and mean postoperative hospital stay was 6.3 days. Fusion was achieved in 93% of levels operated. Incidence of intraoperative and postoperative complications was 1.5% and 9.9%, respectively. Transient thigh pain and/or numbness and hip flexion weakness occurred in 3.0% and 1.2% of patients, respectively. CONCLUSIONS: Early results on the ATP/OLIF technique are promising and warrant further investigation with well-designed prospective randomized studies to provide high-level evidence of the potential advantages over the ALIF and LLIF approaches.
引用
收藏
页码:113 / 123
页数:11
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