Development and Application of Oblique Lumbar Interbody Fusion

Abstract

The present study reviewed the relevant recent literature regarding the development and application of oblique lumbar interbody fusion (OLIF), with a particular focus on its application and associated complications. The study evaluated the rationality of this technique and demonstrated the direction of future research by collecting data on previous operative outcomes and complications. A literature search was performed in Pubmed and Web of Science, including the following keywords and abbreviations: anterior lumbar interbody fusion (ALIF), lateral lumbar interbody fusion (LLIF), direct lateral interbody fusion (DLIF), extreme lateral interbody fusion (XLIF), oblique lateral interbody fusion (OLIF), adjacent segment disease (ASD), and adult degenerative scoliosis (ADS). A search of literature published from January 2005 to January 2019 was conducted and all studies evaluating development and application of OLIF were included in the review. According to the literature, the indications for OLIF are various. OLIF has excellent orthopaedic effects in degenerative scoliosis patients and the incidence of bony fusion is higher than for other approaches. It also provides a better choice for revision surgery. It has various advantages in many aspects, but the complications cannot be ignored. As a new minimally invasive technique, the advantages of OLIF are obvious, but further evaluation is needed to compare its operation-related data with that of traditional open surgery. In addition, more prospective studies are required to compare minimally invasive and open spinal surgery to confirm its specific efficacy, risk, advantages, learning curve, and ultimate clinical efficacy.

Keywords: Complications of OLIF; Development and application; Oblique Lumbar Interbody Fusion (OLIF).

Figure 1

A 37‐year‐old female patient has had ankylosing spondylitis for 18 years. (A)–(C) Preoperative position placement and target level confirmation. (D) The exposure of the operative field. The images taken after the operation are shown in (E) and (F).

Figure 2

(A) Arrow indicates the route to the intervertebral disc and the rectangle shows the position where the cage is inserted. Cross‐section of the MRI determines if it is suitable to perform oblique lumbar interbody fusion (OLIF). (B) CTA is used to find whether there is abnormal vascular malformation to decrease the incidence of vascular injury.

Figure 3

The preoperative sagittal T2‐weighted MRI (A, B) of a 31‐year‐old female patient showed the disruption of intervertebral space 1 week and 2 months after the onset of low back pain, respectively. (C) The disrupted intervertebral disc. The lateral (D–F) radiographs and CT showed oblique lumbar interbody fusion at L2–3 levels intraoperatively, 3 and 6 month postoperatively. Bony fusion was achieved.

Figure 4

A 68‐year‐old woman underwent oblique lumbar interbody fusion (OLIF). The anteroposterior (A) X‐ray radiographs show scoliosis deformity and the Cobb angle is 27°. The X‐ray radiographs (B) and (C) at 1 week and 5 months postoperatively, respectively, show that the Cobb angle decreased 19° and the deformity was rectified remarkably.

Figure 5

Pictures (A) and (C) were taken preoperatively and pictures (B) and (D) were taken after the surgery. The comparison of images showed that a significant increase in the spinal canal area after the operation, showing good effect of indirect decompression of the spinal canal.