Abstract
Extreme lateral interbody fusion (XLIF) has been widely used for minimally invasive anterior lumbar interbody fusion (ALIF), but an approach to L5-S1 is difficult because of the iliac crest. In the current study, we present 2 cases using minimally invasive oblique lateral interbody fusion (OLIF) of L5-S1. The patients showed foraminal stenosis between L5 and S1 and severe low back and leg pain. The patients were placed in a lateral decubitus position and underwent OLIF surgery (using a cage and bone graft from the iliac crest) without posterior decompression. Posterior screws were used in the patients. Pain scores significantly improved after surgery. There was no spinal nerve, major vessel, peritoneal, or urinary injury. OLIF surgery was minimally invasive and produced good surgical results without complications.
Highlights
Open approaches such as anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF), and transforaminal lumbar interbody fusion (TLIF) have been reported to have high rates of success for lumbar spinal fusion [1,2,3], intraoperative concerns and iatrogenic complications are known [4, 5].The minimally invasive lateral transpsoas approach to the lumbar spine is known as extreme lateral interbody fusion (XLIF) [6, 7]
Medtronic developed their oblique lumbar interbody fusion (OLIF) system (OLIF25) using a new device, and this procedure enables the placement of a larger interbody graft into the disk space for anterior column support and segmental sagittal alignment, while minimizing the nerve, muscle, and bone obstacles associated with traditional direct lateral approaches
We evaluated an approach using OLIF for L5-S1 with the patient in a lateral decubitus position
Summary
Open approaches such as anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF), and transforaminal lumbar interbody fusion (TLIF) have been reported to have high rates of success for lumbar spinal fusion [1,2,3], intraoperative concerns and iatrogenic complications are known [4, 5]. Medtronic developed their OLIF system (OLIF25) using a new device, and this procedure enables the placement of a larger interbody graft into the disk space for anterior column support and segmental sagittal alignment, while minimizing the nerve, muscle, and bone obstacles associated with traditional direct lateral approaches. This system can be applied to L5-S1 between major vessels using a lateral decubitus operating position. The purpose of the current study was to present 2 cases using OLIF of L5-S1 in a lateral decubitus position
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