M Behrens Kyle M, Elgafy Hossein
Department of Orthopedics, University of Toledo Medical Centre, Toledo, OH 43614, United States.
World J Orthop. 2025 Mar 18;16(3):100772. doi: 10.5312/wjo.v16.i3.100772.
In this editorial, the authors of this paper comment on the article by Bokov published in the recent issue of . We reviewed a general overview of oblique lumbar interbody fusions (OLIF) and lateral lumbar interbody fusions (LLIF), their indications and complications as an increasingly popular minimally invasive technique to address several lumbar pathologies. This editorial thoroughly discusses and reviews the literature regarding factors affecting outcomes of indirect decompression utilized through OLIF and LLIF procedures. Several parameters play a critical role in patient outcomes including restoration of disc height, foraminal height, central canal squared, and foraminal area. The indirect decompression allows for unbuckling of the ligamentum flavum which can significantly decompress the neural elements as well as aid in reduction of spondylolisthesis. However, the authors further highlight the limitations of indirect decompression and factors that may predict unsuccessful outcomes including bony foraminal stenosis, severe central canal stenosis, and osteoporosis. As a result, failure of indirect decompression can lead to persistent pain, radiculopathy and unsatisfied patients. Spinal surgeons may be left to reimage patients and consider additional procedures with direct decompression.
在这篇社论中，本文作者对博科夫发表于最近一期[期刊名称未给出]的文章进行了评论。我们回顾了斜外侧腰椎椎间融合术（OLIF）和外侧腰椎椎间融合术（LLIF）的总体概况、它们的适应症及并发症，这两种技术作为一种日益流行的微创技术，用于治疗多种腰椎疾病。这篇社论全面讨论并回顾了有关影响通过OLIF和LLIF手术进行间接减压效果的因素的文献。几个参数对患者预后起着关键作用，包括椎间盘高度、椎间孔高度、中央管截面积和椎间孔面积的恢复情况。间接减压可使黄韧带松弛，从而能显著减压神经结构，并有助于复位椎体滑脱。然而，作者进一步强调了间接减压的局限性以及可能预示手术结果不佳的因素，包括骨性椎间孔狭窄、严重的中央管狭窄和骨质疏松。因此，间接减压失败可能导致持续疼痛、神经根病以及患者不满意。脊柱外科医生可能不得不再次对患者进行影像学检查，并考虑采用直接减压的额外手术。
