Clinical and Radiologic Analysis of Minimally Invasive Anterior–Posterior Combined Surgery for Adult Spinal Deformity: Comparison of Oblique Lateral Interbody Fusion at L5/S1 (OLIF51) versus Transforaminal Interbody Fusion
<i>Background and Objectives:</i> Although adult spinal deformity (ASD) surgery brought about improvement in the quality of life of patients, it is accompanied by high invasiveness and several complications. Specifically, mechanical complications of rod fracture, instrumentation failures...
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MDPI AG
2024-01-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/60/1/107 |
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| author | Yoshihisa Kotani Atsushi Ikeura Takahiro Tanaka Takanori Saito |
| author_facet | Yoshihisa Kotani Atsushi Ikeura Takahiro Tanaka Takanori Saito |
| author_sort | Yoshihisa Kotani |
| collection | DOAJ |
| description | <i>Background and Objectives:</i> Although adult spinal deformity (ASD) surgery brought about improvement in the quality of life of patients, it is accompanied by high invasiveness and several complications. Specifically, mechanical complications of rod fracture, instrumentation failures, and pseudarthrosis are still unsolved issues. To better improve these problems, oblique lateral interbody fusion at L5/S1 (OLIF51) was introduced in 2015 at my institution. The objective of this study was to compare the clinical and radiologic outcomes of anterior–posterior combined surgery for ASD between the use of OLIF51 and transforaminal interbody fusion (TLIF) at L5/S1. <i>Materials and Methods:</i> A total of 117 ASD patients received anterior–posterior correction surgeries either with the use of OLIF51 (35 patients) or L5/S1 TLIF (82 patients). In both groups, L1–5 OLIF and minimally invasive posterior procedures of hybrid or circumferential MIS were employed. The sagittal and coronal spinal alignment and spino-pelvic parameters were recorded preoperatively and at follow-up. The quality-of-life parameters and visual analogue scale were evaluated, as well as surgical complications at follow-up. <i>Results:</i> The average follow-up period was thirty months (13–84). The number of average fused segments was eight (4–12). The operation time and estimated blood loss were significantly lower in OLIF51 than in TLIF. The PI-LL mismatch, LLL, L5/S1 segmental lordosis, and L5 coronal tilt were significantly better in OLIF51 than TLIF. The complication rate was statistically equivalent between the two groups. <i>Conclusions:</i> The introduction of OLIF51 for adult spine deformity surgery led to a decrease in operation time and estimated blood loss, as well as improvement in sagittal and coronal correction compared to TLIF. The circumferential MIS correction and fusion with OLIF51 serve as an effective surgical modality which can be applied to many cases of adult spinal deformity. |
| first_indexed | 2024-03-08T10:41:04Z |
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| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-08T10:41:04Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-2b11824847504cbd9df9c0b7b4d23fe42024-01-26T17:35:24ZengMDPI AGMedicina1010-660X1648-91442024-01-0160110710.3390/medicina60010107Clinical and Radiologic Analysis of Minimally Invasive Anterior–Posterior Combined Surgery for Adult Spinal Deformity: Comparison of Oblique Lateral Interbody Fusion at L5/S1 (OLIF51) versus Transforaminal Interbody FusionYoshihisa Kotani0Atsushi Ikeura1Takahiro Tanaka2Takanori Saito3Spine and Nerve Center, Department of Orthopaedic Surgery, Kansai Medical University Medical Center, Moriguchi, Osaka 570-8507, JapanSpine and Nerve Center, Department of Orthopaedic Surgery, Kansai Medical University Medical Center, Moriguchi, Osaka 570-8507, JapanSpine and Nerve Center, Department of Orthopaedic Surgery, Kansai Medical University Medical Center, Moriguchi, Osaka 570-8507, JapanDepartment of Orthopaedic Surgery, Kansai Medical University, Hirakata, Osaka 573-1191, Japan<i>Background and Objectives:</i> Although adult spinal deformity (ASD) surgery brought about improvement in the quality of life of patients, it is accompanied by high invasiveness and several complications. Specifically, mechanical complications of rod fracture, instrumentation failures, and pseudarthrosis are still unsolved issues. To better improve these problems, oblique lateral interbody fusion at L5/S1 (OLIF51) was introduced in 2015 at my institution. The objective of this study was to compare the clinical and radiologic outcomes of anterior–posterior combined surgery for ASD between the use of OLIF51 and transforaminal interbody fusion (TLIF) at L5/S1. <i>Materials and Methods:</i> A total of 117 ASD patients received anterior–posterior correction surgeries either with the use of OLIF51 (35 patients) or L5/S1 TLIF (82 patients). In both groups, L1–5 OLIF and minimally invasive posterior procedures of hybrid or circumferential MIS were employed. The sagittal and coronal spinal alignment and spino-pelvic parameters were recorded preoperatively and at follow-up. The quality-of-life parameters and visual analogue scale were evaluated, as well as surgical complications at follow-up. <i>Results:</i> The average follow-up period was thirty months (13–84). The number of average fused segments was eight (4–12). The operation time and estimated blood loss were significantly lower in OLIF51 than in TLIF. The PI-LL mismatch, LLL, L5/S1 segmental lordosis, and L5 coronal tilt were significantly better in OLIF51 than TLIF. The complication rate was statistically equivalent between the two groups. <i>Conclusions:</i> The introduction of OLIF51 for adult spine deformity surgery led to a decrease in operation time and estimated blood loss, as well as improvement in sagittal and coronal correction compared to TLIF. The circumferential MIS correction and fusion with OLIF51 serve as an effective surgical modality which can be applied to many cases of adult spinal deformity.https://www.mdpi.com/1648-9144/60/1/107adult spinal deformityminimally invasive surgeryoblique lateral interbody fusionOLIF51transforaminal interbody fusion |
| spellingShingle | Yoshihisa Kotani Atsushi Ikeura Takahiro Tanaka Takanori Saito Clinical and Radiologic Analysis of Minimally Invasive Anterior–Posterior Combined Surgery for Adult Spinal Deformity: Comparison of Oblique Lateral Interbody Fusion at L5/S1 (OLIF51) versus Transforaminal Interbody Fusion Medicina adult spinal deformity minimally invasive surgery oblique lateral interbody fusion OLIF51 transforaminal interbody fusion |
| title | Clinical and Radiologic Analysis of Minimally Invasive Anterior–Posterior Combined Surgery for Adult Spinal Deformity: Comparison of Oblique Lateral Interbody Fusion at L5/S1 (OLIF51) versus Transforaminal Interbody Fusion |
| title_full | Clinical and Radiologic Analysis of Minimally Invasive Anterior–Posterior Combined Surgery for Adult Spinal Deformity: Comparison of Oblique Lateral Interbody Fusion at L5/S1 (OLIF51) versus Transforaminal Interbody Fusion |
| title_fullStr | Clinical and Radiologic Analysis of Minimally Invasive Anterior–Posterior Combined Surgery for Adult Spinal Deformity: Comparison of Oblique Lateral Interbody Fusion at L5/S1 (OLIF51) versus Transforaminal Interbody Fusion |
| title_full_unstemmed | Clinical and Radiologic Analysis of Minimally Invasive Anterior–Posterior Combined Surgery for Adult Spinal Deformity: Comparison of Oblique Lateral Interbody Fusion at L5/S1 (OLIF51) versus Transforaminal Interbody Fusion |
| title_short | Clinical and Radiologic Analysis of Minimally Invasive Anterior–Posterior Combined Surgery for Adult Spinal Deformity: Comparison of Oblique Lateral Interbody Fusion at L5/S1 (OLIF51) versus Transforaminal Interbody Fusion |
| title_sort | clinical and radiologic analysis of minimally invasive anterior posterior combined surgery for adult spinal deformity comparison of oblique lateral interbody fusion at l5 s1 olif51 versus transforaminal interbody fusion |
| topic | adult spinal deformity minimally invasive surgery oblique lateral interbody fusion OLIF51 transforaminal interbody fusion |
| url | https://www.mdpi.com/1648-9144/60/1/107 |
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