Department of Orthopaedic Surgery, Loma Linda University Health, Loma Linda, CA, USA.
School of Medicine, Loma Linda University, Loma Linda, CA, USA.
Eur Spine J. 2024 Jul;33(7):2604-2610. doi: 10.1007/s00586-023-08017-4. Epub 2024 Feb 26.
The primary aim of this study was to describe the feasibility, surgical approach window (SAW), and incision line (IL) for oblique lateral interbody fusion at L5-S1 (OLIF51) using computed tomography (CT). A secondary aim was to identify associations among approach characteristics and demographic and anthropometric factors.
We performed a radiographic study of 50 male and 50 female subjects who received abdominal CT imaging. SAW was measured as the distance from the midline to the medial border of the iliac vessel. IL was measured at the skin surface corresponding to the distance between the center of the disc space and SAW lateral margin. OLIF51 feasibility was defined as the existence of at least a 1-cm SAW without retraction of soft tissues.
For the left side, the OLIF51 SAW and IL were 12.1 ± 4.6 and 175.1 ± 55.3 mm. For the right side, these measures were 10.0 ± 4.3 and 185.0 ± 52.5 mm. Correlations of r = 0.648 (p < 0.001) and r = 0.656 (p < 0.001) were observed between weight and IL on the left and right sides, respectively. OLIF51 was not feasible 23% of the time.
To our knowledge, this is the largest CT study to determine the feasibility of performing an OLIF51. Without the use of retraction, OLIF51 is not feasible 23% of the time. Left-sided OLIF51 allows for a larger surgical approach window and smaller incision compared to the right side. Larger incisions are required for adequate surgical exposure in patients with higher weight.
本研究的主要目的是使用计算机断层扫描（CT）描述 L5-S1 斜侧椎间融合术（OLIF51）的可行性、手术入路窗（SAW）和切口线（IL）。次要目的是确定入路特征与人口统计学和人体测量学因素之间的关联。
我们对 50 名男性和 50 名女性接受腹部 CT 成像的受试者进行了放射学研究。SAW 测量为从中线到髂血管内侧边界的距离。IL 在皮肤表面测量，对应于椎间盘空间中心与 SAW 外侧边缘之间的距离。OLIF51 的可行性定义为存在至少 1cm 的 SAW，且软组织无回缩。
对于左侧，OLIF51 的 SAW 和 IL 分别为 12.1±4.6mm 和 175.1±55.3mm。对于右侧，这些测量值分别为 10.0±4.3mm 和 185.0±52.5mm。左侧和右侧的重量与 IL 之间分别观察到 r=0.648（p<0.001）和 r=0.656（p<0.001）的相关性。OLIF51 的可行性为 23%。
据我们所知，这是最大的 CT 研究，用于确定进行 OLIF51 的可行性。在不使用牵引的情况下，OLIF51 的可行性为 23%。与右侧相比，左侧 OLIF51 允许更大的手术入路窗口和更小的切口。对于体重较高的患者，需要更大的切口以获得足够的手术暴露。
