Application of self-anchored lateral lumbar fusion cages in oblique lateral interbody fusion for symptomatic adjacent segment degeneration after lumbar fusion

English Keywords:Self-anchored lateral lumbar fusion cage  Oblique lateral interbody fusion  Posterior lumbar interbody fusion  Adjacent segment disease

English Abstract:

  【Abstract】 Objectives: To evaluate the application effect of self-anchored lateral lumbar fusion cage in the treatment of symptomatic adjacent segment degeneration after lumbar fusion by oblique lateral interbody fusion(OLIF). Methods: Retrospective analysis was performed on 35 patients with symptomatic adjacent segment degeneration after lumbar fusion treated in our hospital from March 2014 to March 2020. 13 patients were treated with OLIF(7 males and 6 females, aged 48－75 years, with a mean age of 56.2±15.4 years)， and 22 patients were treated with transforaminal lumbar interbody fusion(TLIF)(12 males and 10 females, aged 38-76 years, averaged 48.2±24.5 years)． Perioperative conditions, such as operative time, intraoperative blood loss, postoperative drainage volume, length of hospital stay and complications, were recorded for both groups. The clinical efficacy of both groups were assessed by comparing the visual analogue scale(VAS) scores of back pain and lower limb pain and Oswestry disability index(ODI) recorded before surgery, 3 months after operation, and the final follow-up. Results: There were statistically significant differences in operative time, intraoperative blood loss, postoperative drainage volume and length of hospital stay between the two groups(P<0.05). Postoperative complications occurred in 3 cases(23.1%) in the OLIF group, and in 5 cases(22.7%) in the TLIF group. Follow-up period was 35.4±21.9 months(ranged 12-72 months). In the OLIF group, the mean VAS scores of back pain, lower limb pain and ODl were 7.6±1.1, 7.8±1.1, (58.9±10.8)％ before surgery; 1.7±0.3, 1.8±0.2, (19.6±1.5)% at 3 months after the operation; and 0.7±0.3, 0.7±0.3, (18.3±0.7)% at the final follow-up． In the TLIF group, the mean VAS scores of back pain, lower limb pain and ODl were 8.0±1.0, 8.0±1.0, (57.4±11.5)％ before surgery; 1.8±0.3, 1.9±0.3, (20.9±1.2)% at 3 months after the operation; and 0.5±0.1, 0.5±0.2, (19.2±0.8)% at the final follow-up． The VAS scores of back pain, lower limb pain and ODI scores of the two groups of patients at 3 months postoperatively and at the last follow-up were improved compared with those preoperatively(P<0.05). There was no statistically significant difference between the two groups at different points(P>0.05). Conclusions: OLIF with self-anchored lumbar lateral fusion cage is safe and effective in the treatment of adjacent segmental disease after lumbar fusion, and can shorten the operation time and hospital stay, and facilitate early recovery.