Clinical application of the Pivox system during oblique lateral interbody fusion(OLIF) in the treatment of single-segment lumbar spine diseases

English Keywords:Pivox  Oblique lateral interbody fusion  Cage subsidence  Cage displacement

English Abstract:

  【Abstract】 Objectives: To explore the clinical use and observe the clinical efficacy of the Pivox system in oblique lateral interbody fusion(OLIF) in treating single-segment lumbar spinal diseases. Methods: The clinical data of patients with single-segment lumbar spinal diseases(Discogenic low back pain, lumbar spondylolisthesis, lumbar spinal stenosis) who underwent OLIF without posterior instrumentation from May 2020 to January 2021 in our hospital were collected, including 36 males and 33 females, aged 32-79 years old(59.1±5.9 years). And the patients were divided into OLIF stand-alone group(39 patients) and Pivox+OLIF group(30 patients). The perioperative parameters of the two groups of patients were compared, including incision length, operative time, intraoperative blood loss, and length of hospital stay. The visual analogue scale(VAS) and Oswestry disability index(ODI) were assessed before operation, at 1 week, 1, 3, 6 and 12 months after operation for clinical efficacy. The intervertebral disc height, foraminal height and foraminal area before and after operation, and the fusion rate were evaluated and compared between the two groups. Complications were recorded and compared as well. Results: The patients were followed up for 14.0±0.3 months(12-18 months). No significant differences were found between the two groups in gender, age, disease type, operative level, bone mineral density(BMD), or body mass index(BMI)(P>0.05). The operative time in OLIF group was shorter than that in Pivox+OLIF group(P<0.05), while there were no significant differences in blood loss, incision length and hospital stay(P>0.05). The VAS score and ODI index in both groups before surgery were higher than those at 1 week, 1 month, 3 months, 6 months, and 12 months after surgery(P<0.05). No significant differences in VAS and ODI were found at 1 week, 1 month, 3 months, 6 months, and 12 months after surgery between the two groups, respectively(P>0.05). The intervertebral disc height, foraminal height and foraminal area at postoperative 1 week, 6 and 12 months were all greater than those before operation in both groups, while the increase values of intervertebral disc height, foraminal height and foraminal area in Pivox+OLIF group were greater than those in OLIF group at 1 week, and 6 and 12 months after surgery, but without statistical differences(P>0.05). Cage subsidence occurred in both groups, and cage displacement was noticed in two cases in the OLIF group, while none was there in the Pivox+OLIF group. There were no significant differences in fusion rate and incidence of complications between two groups(P>0.05). Conclusions: The short-term effect of Pivox+OLIF procedure in the treatment of single-segment lumbar degenerative diseases is satisfactory, but comparing with stand-alone OLIF, Pivox+OLIF has no obvious advantage in spinal canal decompression and preventing cage subsidence.