First Clinical Medical College, Guangzhou University of Chinese Medicine, 510405 Guangzhou, China.
Department of Orthopedics, The Second Xiangya Hospital of Central South University, 410011 Changsha, China.
Neurochirurgie. 2022 Dec;68(6):575-582. doi: 10.1016/j.neuchi.2022.05.005. Epub 2022 Jun 3.
Oblique lumbar interbody fusion (OLIF) is a minimally invasive lumbar fusion procedure that has flourished in recent years. However, complications related to the anterior-to-psoas (ATP) approach have been reported. The purpose of this study was to assess the OLIF technique using offset design "Dingo" instruments for the treatment of degenerative lumbar disorders.
A retrospective review was performed to identify patients between March 2018 and November 2020 who underwent OLIF with conventional or modified instruments with a minimum follow-up of 12months. Demographic data were recorded. Operation time, intraoperative blood loss, and length of hospital stay were compared between cohorts. Imaging parameters were measured and compared between cohorts before and after surgery. Clinical outcomes were assessed at each follow-up visit. All complications were reviewed.
A total of 80 consecutive patients were included. The mean follow-up times for the conventional group and modified group were 14.5months and 16.3months, respectively. The incidence of hip flexion weakness was 27.5% and 7.5% for the conventional cohort and modified cohort, respectively. The modified group was associated with a shorter operation time, shorter length of hospital stay, higher postoperative disk height and better cage position. The symptoms of all patients improved after surgery. At 1-week follow-up, the modified group showed significantly better clinical scores.
OLIF with modified instruments and techniques shows promising outcomes in reducing approach-related complications. Additionally, the modified technique is associated with a better cage position, shorter length of hospital stay and less postoperative pain in the early period.
斜侧腰椎体间融合术（OLIF）是一种近年来蓬勃发展的微创腰椎融合术。然而，与前腰大肌（ATP）入路相关的并发症已有报道。本研究旨在评估使用“Dingo”偏移设计器械进行 OLIF 治疗退行性腰椎疾病的技术。
回顾性分析 2018 年 3 月至 2020 年 11 月间采用传统或改良器械行 OLIF 治疗的患者，随访时间至少 12 个月。记录患者的人口统计学数据。比较两组患者的手术时间、术中出血量和住院时间。测量并比较两组患者术前和术后的影像学参数。在每次随访时评估临床结果。回顾所有并发症。
共纳入 80 例连续患者。常规组和改良组的平均随访时间分别为 14.5 个月和 16.3 个月。常规组和改良组的髋关节屈曲无力发生率分别为 27.5%和 7.5%。改良组的手术时间更短、住院时间更短、术后椎间盘高度更高、椎间融合器位置更好。所有患者术后症状均得到改善。在术后 1 周随访时，改良组的临床评分显著改善。
使用改良器械和技术的 OLIF 可降低与入路相关的并发症，具有较好的预后。此外，改良技术与更好的椎间融合器位置、更短的住院时间和术后早期更少的疼痛相关。
