Abstract
Patients with degenerative lumbar spondylolisthesis (DLS) often suffer from years of low back pain (LBP) due to instability of the lumbar spine and the reduction of disc height. Since January 2016, we have performed oblique lateral interbody fusion (OLIF) on 154 patients. Among these, 56 patients who suffered from DLS underwent OLIF with stand-alone cages. Forty-two patients with a follow-up time that exceeded 1-year were enrolled for this study. The forty-two patients were followed up for at least one year. Operation segments ranged from L3-4 to L4-5. All the patients were with 1-level fusion. The mean postoperative ventral-disc height and dorsal-disc height increased significantly compared with preoperative (P < 0.05). A significant postoperative increase was also observed in the mean operative segmental lordotic angle and the whole lumbar lordotic angle (P < 0.05). Compared with preoperative, the postoperative VAS significantly decreased with no significant increase in the VAS in the last follow-up. The LBP was significantly relieved. The mean postoperative VAS of LBP decreased significantly compared with the preoperative ((1.6 ± 0.8) vs. (7.8 ± 0.8)). Postoperative complications included psoas major abscess and intervertebral space infection (1/56). Except for one patient whose cage subsided during the last follow-up, the other patients had good cage position. The one whose cage collapsed complained no symptoms including LBP. OLIF with stand-alone cages should be considered as a safe and effective option which can effectively alleviate LBP for the treatment of DLS.
Highlights
Lumbar interbody fusion has been widely used for the treatment of patients with degenerative lumbar spondylolisthesis (DLS) who have failed with nonoperation therapy
Patients with DLS often suffer from years of low back pain (LBP) due to instability of the lumbar spine and the reduction of disc height
All the patients were with 1-level fusion. e mean operation time was 69.7 ± 8.7 min, and the mean estimated blood loss was 92.6 ± 11.7 ml. e mean postoperative ventral-disc height and dorsal-disc height increased significantly compared with preoperative (P < 0.05, Figure 3)
Summary
Lumbar interbody fusion has been widely used for the treatment of patients with degenerative lumbar spondylolisthesis (DLS) who have failed with nonoperation therapy. Anterior or anterolateral approach surgeries for lumbar interbody fusion have been increasingly popular due to the protection of paravertebral muscles. Compared with the anterior lumbar interbody fusion (ALIF), oblique lumbar interbody fusion (OLIF) is an extraperitoneal approach with lower incidence of abdominal complications, vascular injury, and reverse ejaculation [1, 2]. Patients with DLS often suffer from years of LBP due to instability of the lumbar spine and the reduction of disc height. Studies have proved that stand-alone cages in ALIF can effectively restore the disc height and stabilize the spine promoting fusion [1]. We recently attempted using OLIF with stand-alone cages for the treatment of DLS to provide immediate stability. We recently attempted using OLIF with stand-alone cages for the treatment of DLS to provide immediate stability. e purpose of our study was to assess the feasibility and clinical outcomes of patients with DLS after this technique
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