Oblique Lateral Lumbar Interbody Fusion (OLLIF): Technical Notes and Early Results of a Single Surgeon Comparative Study.
Oblique Lateral Lumbar Interbody Fusion (OLLIF): Technical Notes and Early Results of a Single Surgeon Comparative Study.
复制标题
DOI：
10.7759/cureus.351
复制
发表时间：
2015-10-15
期刊：
影响因子：
--
通讯作者：
Abbasi A
中科院分区：
文献类型：
--
作者：
Abbasi H;Abbasi A
下背痛是西方世界最普遍和最昂贵的健康状况之一。标准的治疗方法，椎间融合术，是一种侵入性手术，需要剥离肌肉和软组织，导致手术并发症。目前的微创（MI）脊柱融合术在技术上要求很高并且受到技术限制。目的：斜向腰椎外侧椎间融合术（OLLIF）是一种克服这些并发症的腰椎融合新技术。结局指标包括患者人口统计学资料、报告的结局和手术结局。研究设计/设置：Kambin三角可以很容易地定位为一个安静的窗口与电生理探头。椎间盘切除术通过直径为10 mm的单个入路进行。椎间盘切除术后，用浸泡在自体骨髓中的β-磷酸三钙填充椎间隙，抽吸并插入融合器。最后，进行微创后路固定。方法：OLLIF的主要创新是在双侧透视的辅助下通过Kambin三角进入椎间盘。结果如下：我们提供的数据来自128个节段的69例连续OLLIF手术，对照组为125个节段的55例连续开放式转化腰椎椎间融合术（TLIF）。单节段OLLIF的平均手术时间为69分钟（min），失血量为29 ml。手术时间大约是开放式TLIF的两倍（平均：135分钟），失血量比TLIF减少80%以上（平均：355 ml）。结论：OLLIF是一种微创融合术，与开放手术相比，可显著缩短手术时间。OLLIF克服了传统开放融合的困难，使其成为一种安全且技术要求低于开放或微创TLIF的手术。
Background context: Lower back pain is one of the most prevalent and expensive health conditions in the Western world. The standard treatment, interbody fusion, is an invasive procedure that requires the stripping of muscles and soft tissue, leading to surgical morbidity. Current minimally invasive (MI) spinal fusions are technically demanding and suffer from technical limitations. Purpose: Oblique lumbar lateral interbody fusion (OLLIF) is a new technique for fusion of the lumbar spine that overcomes these complications. Outcome measures include patient demographics, reported outcomes, and surgical outcomes. Study design/Setting: Kambin's Triangle can easily be located as a silent window with an electrophysiological probe. Discectomy is performed through a single access portal with a 10 mm diameter. After a discectomy, the disc space is packed with beta-tricalcium phosphate soaked in autologous bone marrow, aspirated, and the cage is inserted. Finally, a minimally invasive posterior fixation is performed. Methods: OLLIF’s major innovation is to approach the disc through Kambin’s Triangle, aided by bilateral fluoroscopy. Results: We present data from 69 consecutive OLLIF surgeries on 128 levels with a control group of 55 consecutive open transformational lumbar interbody fusions (TLIFs) on 125 levels. For a single level OLLIF, the mean surgery time is 69 minutes (min) and blood loss is 29 ml. Surgery time was approximately twice as fast as open TLIF (mean: 135 min) and blood loss is reduced by over 80% compared to TLIF (mean: 355 ml). Conclusions: OLLIF is a minimally invasive fusion that significantly reduces surgery times compared to open surgery. OLLIF overcomes the difficulties of traditional open fusions, making it a safe and technically less demanding surgery than open or minimally invasive TLIF.