Short-term clinical of oblique lateral interbody fusion in the treatment of mild-to- moderate of degenerative lumbar spinal stenosis

English Keywords:Lumbar spinal stenosis  Oblique lateral lumbar interbody fusion  Short-term effects

English Abstract:

  【Abstract】 Objectives: To investigate the short-term efficacy of oblique lateral interbody fusion(OLIF) in treating mild-to-moderate lumbar spinal stenosis(LSS). Methods: 35 patients with mild-to-moderate LSS treated with OLIF between May 2018 and May 2020 were analyzed retrospectively, including 25 males and 10 females, aged 50-74(60.3±10.7) years old. The patients were followed up for 12-28(18.3±3.7) months. The operative time, intraoperative bleeding, and complications were recorded; At preoperation, 1 week, and 3, 6 and 12 months after surgery, the visual analogue scale(VAS) for lumbar and leg pain and Oswestry disability index(ODI) were compared to evaluate clinical efficacy; And lumbar X-ray, CT, and MRI were performed at the same time to measure and evaluate the height of the intervertebral space, size of intervertebral foramen, area of dural sac and sagittal diameter, lordotic angle of intervertebral space, lordotic angle of lumbar spine, and their respective differences between before and after operation, as well as between each postoperative time point were analyzed; The complications and fusion conditions at each time point were also documented. Results: The operative time was 30-100(70.5±20.3)min, and intraoperative bleeding was 20-120(60.3±20.2)mL. The lumbar and leg pain VAS scores and ODI at postoperative 1 week, and 3, 6 and 12 months were significantly improved compared with those before operation, and the differences were statistically significant(P＜0.05), while there was no statistical significance when compared pairwisely between postoperative time points(P＞0.05). At postoperative 1 week, and 3, 6 and 12 months, the intervertebral space height, intervertebral lordotic angle and lumbar lordotic angle, left and right intervertebral foramina sizes, dural sac areas, and sagittal diameters increased significantly compared with those before operation, with statistically significance(P＜0.05), and no statistical difference was found when compared pairwisely between postoperative time points for each imaging parameter(P>0.05). According to the CT image evaluation 1 year after operation, the overall fusion rate was 94.2%(33/35 cases). No serious complications such as nerve and vascular injury occurred; 3 cases of postoperative hip flexion weakness and anterior thigh numbness were relieved after 1 month of symptomatic treatment with conservative therapy; 2 cases of fusion device sinking of end-plate cutting were revised in the second stage and underwent posterior muscular gap approach internal fixation. Conclusions: OLIF has satisfactory short-term clinical efficacy in the treatment of mild-to-moderate LSS.