The radiologic and clinical outcomes of oblique lateral interbody fusion for correction of adult degenerative lumbar deformity

Ravish Shammi Patel, Seung-Woo Suh, Seong Hyun Kang, Ki Youl Nam, Shiblee Sabir Siddiqui, Dong Gune Chang, Jae Yang

Research output: Contribution to journalArticle

Abstract

Background: Osteotomies aimed at correcting adult spinal deformity are associated with higher complications and perioperative morbidity. Recently, oblique lumbar interbody fusion (OLIF) was introduced for degenerative lumbar diseases. The aim of our study is to demonstrate the effectiveness of OLIF on the management of adult degenerative lumbar deformity (ADLD). Materials and Methods: Patients with ADLD who underwent deformity correction and decompression using OLIF and posterior instrumentation were enrolled. For radiologic evaluation, Cobb's angle (CA), sagittal vertical axis (SVA), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic tilt (PT), sacral slope (SS), and pelvic incidence (PI) were evaluated. Visual analog scale (VAS), Oswestry disability index (ODI), and perioperative parameters were recorded for clinical evaluation. Results: Fifteen patients with a mean age of 67 years (63-74 years) were enrolled prospectively and an average of 3 OLIFs (range 1-4) was performed. Posterior instrumentations were done at average of six levels (range 4-8). The mean operative blood loss was 863 ml (range 500-1400 ml) with a mean surgical duration of 7 h (range 3-11 h). SVA, TK, LL, CA, PT, and SS showed significant correction (P < 0.05) in immediate postoperative period and all parameters except TK were maintained at final followup. At the end of 24 months of average followup, 86% (13/15) showed fusion. VAS (leg pain), VAS (back pain), and ODI improved by 74% (range 40-100), 58% (range 20%-80%), and 69.5% (range 4%-90%), respectively. There were two major complications requiring revision (1 infection and 1 adjacent vertebral body fracture). Transient hip weakness present in two patients (13%) recovered within 6 weeks. Conclusions: OLIF gives favorable short term clinical and radiological outcomes in patients of ADLD. It could potentially reduce the need for morbid pelvic fixation and posterior osteotomies in patients with degenerative lumbar deformity.

Original languageEnglish
Pages (from-to)502-509
Number of pages8
JournalIndian Journal of Orthopaedics
Volume53
Issue number4
DOIs
Publication statusPublished - 2019 Jul 1

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Kyphosis
Lordosis
Thorax
Osteotomy
Visual Analog Scale
Pain Measurement
Back Pain
Decompression
Postoperative Period
Hip
Leg
Morbidity
Incidence
Infection

Keywords

  • Adult deformity
  • degenerative lumbar deformity
  • degenerative lumbar kyphoscoliosis
  • oblique lateral interbody fusion
  • spine

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

The radiologic and clinical outcomes of oblique lateral interbody fusion for correction of adult degenerative lumbar deformity. / Patel, Ravish Shammi; Suh, Seung-Woo; Kang, Seong Hyun; Nam, Ki Youl; Siddiqui, Shiblee Sabir; Chang, Dong Gune; Yang, Jae.

In: Indian Journal of Orthopaedics, Vol. 53, No. 4, 01.07.2019, p. 502-509.

Research output: Contribution to journalArticle

Patel, Ravish Shammi ; Suh, Seung-Woo ; Kang, Seong Hyun ; Nam, Ki Youl ; Siddiqui, Shiblee Sabir ; Chang, Dong Gune ; Yang, Jae. / The radiologic and clinical outcomes of oblique lateral interbody fusion for correction of adult degenerative lumbar deformity. In: Indian Journal of Orthopaedics. 2019 ; Vol. 53, No. 4. pp. 502-509.
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AU - Nam, Ki Youl

AU - Siddiqui, Shiblee Sabir

AU - Chang, Dong Gune

AU - Yang, Jae

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N2 - Background: Osteotomies aimed at correcting adult spinal deformity are associated with higher complications and perioperative morbidity. Recently, oblique lumbar interbody fusion (OLIF) was introduced for degenerative lumbar diseases. The aim of our study is to demonstrate the effectiveness of OLIF on the management of adult degenerative lumbar deformity (ADLD). Materials and Methods: Patients with ADLD who underwent deformity correction and decompression using OLIF and posterior instrumentation were enrolled. For radiologic evaluation, Cobb's angle (CA), sagittal vertical axis (SVA), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic tilt (PT), sacral slope (SS), and pelvic incidence (PI) were evaluated. Visual analog scale (VAS), Oswestry disability index (ODI), and perioperative parameters were recorded for clinical evaluation. Results: Fifteen patients with a mean age of 67 years (63-74 years) were enrolled prospectively and an average of 3 OLIFs (range 1-4) was performed. Posterior instrumentations were done at average of six levels (range 4-8). The mean operative blood loss was 863 ml (range 500-1400 ml) with a mean surgical duration of 7 h (range 3-11 h). SVA, TK, LL, CA, PT, and SS showed significant correction (P < 0.05) in immediate postoperative period and all parameters except TK were maintained at final followup. At the end of 24 months of average followup, 86% (13/15) showed fusion. VAS (leg pain), VAS (back pain), and ODI improved by 74% (range 40-100), 58% (range 20%-80%), and 69.5% (range 4%-90%), respectively. There were two major complications requiring revision (1 infection and 1 adjacent vertebral body fracture). Transient hip weakness present in two patients (13%) recovered within 6 weeks. Conclusions: OLIF gives favorable short term clinical and radiological outcomes in patients of ADLD. It could potentially reduce the need for morbid pelvic fixation and posterior osteotomies in patients with degenerative lumbar deformity.

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