Abbasi Ali, Khaghany Kamran, Orandi Vali, Abbasi Hamid
Internal Medicine, Pritzker School of Medicine, Chicago, USA.
Radiology, Lake Region Healthcare, Fergus Falls, USA.
Cureus. 2019 Feb 7;11(2):e4029. doi: 10.7759/cureus.4029.
Oblique lateral lumbar interbody fusion (OLLIF) is a novel operation for fusions of the lumbar spine from T12-S1. In OLLIF, the disk is approached from an oblique lateral angle guided by electrophysiological monitoring and biplanar fluoroscopy; the disk space is accessed through Kambin's triangle. We present perioperative, clinical, patient-reported and radiological outcomes from a series of 303 OLLIF procedures on 568 levels performed by the same surgeon. For a single-level OLLIF, mean surgery time was 56.6 ± 37.7 minutes, with a blood loss of 42.2 ± 31.1 mL, fluoroscopy time of 198.8 ± 87.2 seconds and a hospital stay of 2.2 ± 1.7 days. At the one-year follow-up, 10-point pain scale scores improved from 8.6 ± 1.3 to 4.1 ± 3.0 (p < 0.001). Total Oswestry disability index score improved from 56.6% ± 15.3% to 38.6% ± 21.4% (p < 0.001). At the one-year follow-up, 15 (5%) patients had mild nerve root irritation defined as sensory symptoms and motor weakness better than 4/5. Only one patient had neuropraxia due to weakness (3/5). There was one case (0.3%) of superficial wound infection and one case of bleeding into the psoas major. Reoperation within one year was performed for 14 (4.7%) patients. Interbody fusion was achieved in 98.7% of levels. While OLLIF has previously been described, this study is the first to present clinical, patient-reported, and radiological outcomes of OLLIF. Review of the literature shows that OLLIF produces perioperative outcomes, complication rates, and fusion rates that compare favorably with similar procedures. We establish that OLLIF is a safe, efficient and efficacious procedure for fusions of the lumbar spine.
斜外侧腰椎椎间融合术（OLLIF）是一种用于T12 - S1节段腰椎融合的新型手术。在OLLIF手术中，通过电生理监测和双平面荧光透视引导，从斜外侧角度进入椎间盘；经Kambin三角进入椎间隙。我们展示了由同一位外科医生进行的一系列303例OLLIF手术（共568个节段）的围手术期、临床、患者报告及影像学结果。对于单节段OLLIF，平均手术时间为56.6±37.7分钟，失血量为42.2±31.1毫升，透视时间为198.8±87.2秒，住院时间为2.2±1.7天。在一年随访时，10分制疼痛评分从8.6±1.3改善至4.1±3.0（p<0.001）。Oswestry功能障碍指数总分从56.6%±15.3%改善至38.6%±21.4%（p<0.001）。在一年随访时，15例（5%）患者出现轻度神经根刺激，表现为感觉症状和肌力减弱，肌力优于4/5。仅1例患者因肌力减弱（3/5）出现神经失用。有1例（0.3%）浅表伤口感染和1例腰大肌出血。14例（4.7%）患者在一年内进行了再次手术。椎间融合在98.7%的节段实现。虽然此前已有关于OLLIF的描述，但本研究是首个展示OLLIF临床、患者报告及影像学结果的研究。文献综述表明，OLLIF的围手术期结果、并发症发生率和融合率与类似手术相比具有优势。我们证实OLLIF是一种用于腰椎融合的安全、高效且有效的手术。
