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. 2020 May 29:2020:4610128.
doi: 10.1155/2020/4610128. eCollection 2020.

Comparing Oblique Lumbar Interbody Fusion with Lateral Screw Fixation and Transforaminal Full-Endoscopic Lumbar Discectomy (OLIF-TELD) and Posterior Lumbar Interbody Fusion (PLIF) for the Treatment of Adjacent Segment Disease

Zhuo Yang  1 , Jianjun Chang  2 , Lin Sun  2 , Chien-Min Chen  3   4   5 , Haoyu Feng  2
Affiliations

Comparing Oblique Lumbar Interbody Fusion with Lateral Screw Fixation and Transforaminal Full-Endoscopic Lumbar Discectomy (OLIF-TELD) and Posterior Lumbar Interbody Fusion (PLIF) for the Treatment of Adjacent Segment Disease

Zhuo Yang et al. Biomed Res Int. .

Abstract

Background: A potential long-term complication of lumbar fusion is the development of adjacent segment disease (ASD), which may require surgical intervention and adversely affect outcomes. A high incidence of recurrent ASD was reported in patients who underwent the second (repeat) PLIF for symptomatic ASD. Herein, a feasible method, oblique lumbar interbody fusion combined with transforaminal endoscopic lumbar discectomy (OLIF-TELD) for dealing with adjacent lumbar disc herniation with upward or downward migration after lumbar spinal fusion, was proposed.

Methods: A total of 19 patients who underwent revision surgery at ASD were consecutively enrolled. Clinical efficacy analysis included operative time, intraoperative bleeding, visual analogue scale (VAS) score, Oswestry dysfunction index (ODI) score, and Japanese orthopaedic association (JOA) assessment treatment score.

Results: Among them, 11 patients were treated in a new surgical strategy, which is OLIF-TELD, and 8 patients underwent PLIF. There was no statistically significant difference between the two groups in terms of age, gender, and preoperative scores of VAS, ODI, and JOA. The operative duration was shorter, and intraoperative bleeding was less in the OLIF-TELD group compared with the PLIF group. PLIF had the greatest blood loss, and the OLIF-TELD group had lower VAS scores than the PLIF group postoperatively. The symptoms of all patients improved postoperatively with statistical significance.

Conclusion: OLIF with lateral screw fixation combined with TELD may be an alternative surgical method for the treatment of adjacent lumbar disc herniation with upward or downward migration after lumbar fusion surgery.

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Conflict of interest statement

All authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Lumbar MRI shows L3-4 adjacent segment degeneration and lumbar disc herniation with upward migration.
Figure 2
Figure 2
Intraoperative fluoroscopic images showing direct decompression under endoscopic view.
Figure 3
Figure 3
Radiographic images showed the surgical process of OLIF with lateral screw fixation.
Figure 4
Figure 4
A case of PLIF surgery. (a) Preoperative Lumbar MRI images show L3/L4 intervertebral disk prolapse. (b) Postoperative frontal and lateral X-ray images.
See this image and copyright information in PMC

References

    1. Zhang C., Berven S. H., Fortin M., Weber M. H. Adjacent segment degeneration versus disease after lumbar spine fusion for degenerative pathology. Clinical Spine Surgery. 2016;29(1):21–29. doi: 10.1097/BSD.0000000000000328. - DOI - PubMed
    1. Videbaek T. S., Egund N., Christensen F. B., Grethe Jurik A., Bunger C. E. Adjacent segment degeneration after lumbar spinal fusion: the impact of anterior column support: a randomized clinical trial with an eight- to thirteen-year magnetic resonance imaging follow-up. Spine (Phila Pa 1976) 2010;35(22):1955–1964. doi: 10.1097/BRS.0b013e3181e57269. - DOI - PubMed
    1. Ekman P., Moller H., Shalabi A., Yu Y. X., Hedlund R. A prospective randomised study on the long-term effect of lumbar fusion on adjacent disc degeneration. European Spine Journal. 2009;18(8):1175–1186. doi: 10.1007/s00586-009-0947-3. - DOI - PMC - PubMed
    1. Saavedra-Pozo F. M., Deusdara R. A., Benzel E. C. Adjacent segment disease perspective and review of the literature. The Ochsner Journal. 2014;14(1):78–83. - PMC - PubMed
    1. Virk S. S., Niedermeier S., Yu E., Khan S. N. Adjacent segment disease. Orthopedics. 2014;37(8):547–555. doi: 10.3928/01477447-20140728-08. - DOI - PubMed

Supplementary concepts