Li Lei, Wang Yan, Zhang Hao, Han Jialuo, Qu Changpeng, Sun Yihao, Tao Hao, Ma Xuexiao
Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.
Orthop Surg. 2025 Apr;17(4):1114-1123. doi: 10.1111/os.14363. Epub 2025 Jan 23.
The advent of O-arm navigation optimized the oblique lumbar interbody fusion (OLIF) procedure, allowing the operator to simultaneously perform OLIF and percutaneous posterior pedicle screw implantation without patient position change, thus improving the fluency and accuracy of the OLIF procedure (called as OLIF360). Nevertheless, a consensus regarding its suitability for patients with severe spinal stenosis remains elusive. This study aims to investigate the clinical efficacy of OLIF360 and its imaging changes in severe lumbar spinal stenosis cases.
This retrospective study analyzed clinical data from 63 patients with severe lumbar spinal stenosis. Fourteen patients were treated with OLIF360, and another 37 patients were treated with posterior lumbar interbody fusion (PLIF). Lumbar spinal stenosis was assessed using the modified Schizas classification. Clinical efficacy scale scores and postoperative imaging parameter changes were compared between the two groups. Shapiro-Wilk, t-tests or Mann-Whitney U tests, repeated measures ANOVA, and Bonferroni post hoc tests were applied for statistical analysis.
Both groups showed significant improved pain (p < 0.05). At 1-month and 3-month postoperative follow-ups, OLIF360 group scores superior in Visual Analog Scale than PLIF group (p < 0.05). Greater disc height and lumbar lordosis were displayed in OLIF360 group than PLIF group (p < 0.05). No significant difference in screw placement accuracy between groups was observed. Moreover, significant increases in spinal canal area postoperatively (71.04 ± 6.27 mm preop to 109.65 ± 12.34 mm postop, p < 0.05) and bilateral foraminal areas were found in the OLIF360 group.
OLIF360 can have promising short-term efficacy for severe lumbar stenosis treatment with shorter recovery time than PLIF.
O型臂导航技术的出现优化了斜外侧腰椎椎间融合术（OLIF），使术者能够在不改变患者体位的情况下同时进行OLIF和经皮后路椎弓根螺钉植入，从而提高了OLIF手术（称为OLIF360）的流畅性和准确性。然而，对于其在严重椎管狭窄患者中的适用性仍未达成共识。本研究旨在探讨OLIF360在严重腰椎管狭窄病例中的临床疗效及其影像学变化。
本回顾性研究分析了63例严重腰椎管狭窄患者的临床资料。14例患者接受OLIF360治疗，另外37例患者接受后路腰椎椎间融合术（PLIF）治疗。采用改良的Schizas分类法评估腰椎管狭窄情况。比较两组的临床疗效量表评分和术后影像学参数变化。采用Shapiro-Wilk检验、t检验或Mann-Whitney U检验、重复测量方差分析和Bonferroni事后检验进行统计分析。
两组患者的疼痛均有显著改善（p < 0.05）。术后1个月和3个月随访时，OLIF360组的视觉模拟量表评分优于PLIF组（p < 0.05）。OLIF360组的椎间盘高度和腰椎前凸大于PLIF组（p < 0.05）。两组之间的螺钉置入准确性无显著差异。此外，OLIF360组术后椎管面积（术前71.04 ± 6.27 mm至术后109.65 ± 12.34 mm，p < 0.05）和双侧椎间孔面积显著增加。
OLIF360在治疗严重腰椎管狭窄方面具有良好的短期疗效，恢复时间比PLIF短。
