Limthongkul Worawat, Chaiwongwattana Bandid, Kerr Stephen J, Tanasansomboon Teerachat, Kotheeranurak Vit, Yingsakmongkol Wicharn, Singhatanadgige Weerasak
Department of Orthopedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Center of Excellence in Biomechanics and Innovative Spine Surgery, Chulalongkorn University, Bangkok, Thailand.
Neurospine. 2024 Sep;21(3):845-855. doi: 10.14245/ns.2448344.172. Epub 2024 Sep 30.
Oblique lateral interbody fusion (OLIF) is a minimally invasive procedure for stabilizing the spine and indirectly decompressing the neural elements. There is sparse data on unsatisfactory outcomes that require additional interventions (surgery or intervention) after OLIF. This study aimed to identify the causes, and risk factors of these reintervention.
This was a single-center retrospective study of the patients who underwent the OLIF procedure from June 2016 to March 2023. Several clinical and radiographic parameters were studied. We also analyzed associations between several potential risk factors and the reintervention following OLIF.
A total of 231 patients were included. Over an average of 2.5 years of follow-up, 28 patients (12.1%) required a reintervention. Adjacent segment disease (ASD) was the most common cause of reintervention. The risk factors associated with reintervention were previous surgery (adjusted odds ratio [aOR], 4.44; 95% confidence interval [CI], 1.21-16.33; p=0.02) and high preoperative Oswestry Disability Index (ODI) scores (aOR, 1.04; 95% CI, 1.00-1.08; p=0.03). Although increasing the duration of follow-up was not statistically significant, the 95% CI was consistent with an increased risk of reintervention with longer follow-up (OR, 1.18; 95% CI, 0.94-1.50).
This study showed that patients with prior lumbar surgery and high preoperative ODI scores were more likely to require additional intervention after the OLIF procedure. In addition, an increasing duration of follow-up was associated with an increased risk of reintervention. The most common reason for reintervention was ASD after OLIF.
斜外侧椎间融合术（OLIF）是一种用于稳定脊柱并间接减压神经结构的微创手术。关于OLIF术后效果不佳需要额外干预（手术或介入）的数据稀少。本研究旨在确定这些再次干预的原因及危险因素。
这是一项对2016年6月至2023年3月期间接受OLIF手术患者的单中心回顾性研究。研究了多个临床和影像学参数。我们还分析了几个潜在危险因素与OLIF术后再次干预之间的关联。
共纳入231例患者。平均随访2.5年，28例患者（12.1%）需要再次干预。相邻节段疾病（ASD）是再次干预最常见的原因。与再次干预相关的危险因素为既往手术（调整比值比[aOR]，4.44；95%置信区间[CI]，1.21 - 16.33；p = 0.02）和术前Oswestry功能障碍指数（ODI）评分高（aOR，1.04；95% CI，1.00 - 1.08；p = 0.03）。虽然随访时间延长在统计学上无显著意义，但95% CI与随访时间延长导致再次干预风险增加一致（OR，1.18；95% CI，0.94 - 1.50）。
本研究表明，既往有腰椎手术史且术前ODI评分高的患者在OLIF术后更有可能需要额外干预。此外，随访时间延长与再次干预风险增加相关。再次干预最常见的原因是OLIF术后的ASD。
