Complications and Prevention Strategies of Oblique Lateral Interbody Fusion Technique

Objective To analyze the early complications and causes of oblique lateral interbody fusion, and put forward preventive measures. Methods There were 235 patients (79 males and 156 females) analyzed in our study from October 2014 to May 2017. The average age was 61.9 ± 0.21 years (from 32 to 83 years...

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Published in:	Orthopaedic surgery Vol. 10; no. 2; pp. 98 - 106
Main Authors:	Zeng, Zhong‐you, Xu, Zhao‐wan, He, Deng‐wei, Zhao, Xing, Ma, Wei‐hu, Ni, Wen‐fei, Song, Yong‐xing, Zhang, Jian‐qiao, Yu, Wei, Fang, Xiang‐qian, Zhou, Zhi‐jie, Xu, Nan‐jian, Huang, Wen‐jian, Hu, Zhi‐chao, Wu, Ai‐lian, Ji, Jian‐fei, Han, Jian‐fu, Fan, Shun‐wu, Zhao, Feng‐dong, Jin, Hui, Pei, Fei, Fan, Shi‐yang, Sui, De‐xiu
Format:	Journal Article
Language:	English
Published:	Melbourne John Wiley & Sons Australia, Ltd 01-05-2018 John Wiley & Sons, Inc
Subjects:	Adult Aged Aged, 80 and over Clinical Complications Female Follow-Up Studies Humans Intraoperative Complications - etiology Intraoperative Complications - prevention & control Lumbar Lumbar Vertebrae - diagnostic imaging Lumbar Vertebrae - injuries Lumbar Vertebrae - surgery Male Middle Aged Muscle Weakness - etiology Muscle Weakness - prevention & control Oblique lateral interbody fusion Orthopedics Pedicle screw Pedicle Screws Postoperative Complications - etiology Postoperative Complications - prevention & control Radiography Spinal Fractures - diagnostic imaging Spinal Fractures - etiology Spinal Fractures - prevention & control Spinal Fusion - adverse effects Spinal Fusion - instrumentation Spinal Fusion - methods Surgical outcomes Tomography, X-Ray Computed Trauma, Nervous System - etiology Trauma, Nervous System - prevention & control Vascular System Injuries - etiology Pedicle screw Oblique lateral interbody fusion Lumbar Complications
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Summary:	Objective To analyze the early complications and causes of oblique lateral interbody fusion, and put forward preventive measures. Methods There were 235 patients (79 males and 156 females) analyzed in our study from October 2014 to May 2017. The average age was 61.9 ± 0.21 years (from 32 to 83 years). Ninety‐one cases were treated with oblique lateral interbody fusion (OLIF) alone (OLIF alone group) and 144 with OLIF combined with posterior pedicle screw fixation through the intermuscular space approach (OLIF combined group). In addition, 137/144 cases in the combined group were primarily treated by posterior pedicle screw fixation, while the treatments were postponed in 7 cases. There were 190 cases of single fusion segments, 11 of 2 segments, 21 of 3 segments, and 13 of 4 segments. Intraoperative and postoperative complications were observed. Results Average follow‐up time was 15.6 ± 7.5 months (ranged from 6 to 36 months). Five cases were lost to follow‐up (2 cases from the OLIF alone group and 3 cases from the OLIF combined group). There were 7 cases of vascular injury, 22 cases of endplate damage, 2 cases of vertebral body fracture, 11 cases of nerve injury, 18 cases of cage sedimentation or cage transverse shifting, 3 cases of iliac crest pain, 1 case of right psoas major hematoma, 2 cases of incomplete ileus, 1 case of acute heart failure, 1 case of cerebral infarction, 3 case of left lower abdominal pain, 9 cases of transient psoas weakness, 3 cases of transient quadriceps weakness, and 8 cases of reoperation. The complication incidence was 32.34%. Thirty‐three cases occurred in the OLIF alone group, with a rate of 36.26%, and 43 cases in the group of OLIF combined posterior pedicle screw fixation, with a rate of 29.86%. Fifty‐seven cases occurred in single‐segment fusion, with a rate of 30.0% (57/190), 4 cases occurred in two‐segment fusion, with a rate of 36.36% (4/11), 9 cases occurred in three‐segment fusion, with a rate of 42.86% (9/21), and 6 cases occurred in four‐segment fusion, with a rate of 46.15% (6/13). Conclusion In summary, OLIF is a relatively safe and very effective technique for minimally invasive lumbar fusion. Nonetheless, it should be noted that OLIF carries the risk of complications, especially in the early stage of development.
Bibliography:	Disclosure: This study was supported by the National Natural Science Foundation of China (81271971, 81472064), the Zhejiang Provincal Natural Science Foundation (LQ13H060002, LQ15H090002), the Zhejiang Provincal Medical and Health General Project (2015KYA133), the Zhejiang Provincal Medical and Health Research Fund Project (2017KY091), and the Zhejiang Provincal Education Department Project (Y201017108). These authors contributed equally to this work, and are co‐first authors.
ISSN:	1757-7853 1757-7861
DOI:	10.1111/os.12380