Factors that influence the results of indirect decompression employing oblique lumbar interbody fusion

Andrey E Bokov ¹, Svetlana Y Kalinina ², Mingiyan I Khaltyrov ³

⁰Department of Neurosurgery, Institute of Traumatology and Orthopedics, Privolzhsky Research Medical University, Nizhny Novgorod, 603005, Russia. andrei_bokov@mail.ru.

World Journal of Orthopedics +

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August 21, 2024

View abstract on PubMed

Summary

Anterior reconstruction with oblique lumbar interbody fusion (OLIF) effectively decompress lumbar spinal stenosis. However, vertebral canal square below 80 mm² or lateral recess depth less than 3 mm may indicate failure, necessitating further intervention.

Area Of Science

Spine surgery
Neurosurgery
Orthopedic surgery

Background

Indirect decompression via anterior reconstruction is a potential benefit for spinal stenosis.
High revision surgery rates necessitate predictive models for radiographic and clinical outcomes.

Purpose Of The Study

To identify factors influencing radiographic and clinical outcomes of indirect decompression in lumbar spinal stenosis patients.

Main Methods

A single-center study evaluated 80 patients with lumbar spinal stenosis and instability.
Patients underwent oblique lumbar interbody fusion (OLIF) with percutaneous pedicle screw fixation.
Radiographic outcomes were assessed via CT scans, and clinical outcomes using the MacNab scale.

Main Results

OLIF significantly increased disc space height, vertebral canal square, and lateral canal depth (P < 0.0001).
Median vertebral canal square increase was 24.5% with segment height restoration and 49.5% with slip reduction.
7.5% of patients had unsatisfactory results due to residual nerve root compression.

Conclusions

Anterior reconstruction with OLIF enhances disc height and reduces vertebral slip in degenerative spondylolisthesis.
Vertebral canal square < 80 mm² and lateral recess depth < 3 mm predict indirect decompression failure.
Failure may require direct microsurgical decompression.

Keywords:

Anterior reconstruction Central lumbar spinal stenosis Degenerative spondylolisthesis Indirect decompression Lateral recess stenosis Oblique lateral interbody fusion Spinal instability