nach oben

European Journal of Orthopaedic Surgery & Traumatology

Erschienen in:

26.11.2021 | General Review

Lumbar interbody fusion using oblique (OLIF) and lateral (LLIF) approaches for degenerative spine disorders: a meta-analysis of the comparative studies

verfasst von: Luca Ricciardi, Amedeo Piazza, Mattia Capobianco, Giuseppe Maria Della Pepa, Massimo Miscusi, Antonino Raco, Alba Scerrati, Teresa Somma, Giorgio Lofrese, Carmelo Lucio Sturiale

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 1/2023

Einloggen, um Zugang zu erhalten

Abstract

Study design

Systematic review and meta-analysis.

Objective

Historically, posterior approaches to the lumbar spine have allowed surgeons to manage degenerative conditions affecting the lumbar spine. However, spinal muscles injury, post-surgical vertebral instability, cerebrospinal fluid (CSF) leakage, and failed back surgery syndrome (FBSS) represent severe complications that may occur after these surgeries. Lumbar interbody fusion using anterior (ALIF), oblique (OLIF), or lateral (LLIF) approaches may represent valuable surgical alternatives, in case fusion is indicated on single or multiple levels.

Methods

The present study is a systematic review, conducted according to the PRISMA statement, of comparative studies on OLIF, and LLIF for degenerative spine disorders, and a meta-analysis of their clinical-radiological outcomes and complications.

Results

After screening 1472 papers on PubMed, Scopus, and Cochrane Library, only 3 papers were included in the present study. 318 patients were included for data meta-analysis, 128 in OLIF group, and 190 in LLIF group. There were no significative differences in terms of surgical (intraoperative blood loss and surgical duration) and clinical (VAS-back, VAS-leg, and ODI scores) outcomes, or fusion rates at last follow-up (> 2 years). Significantly higher rates of abdominal complications, system failure, and vascular injuries were recorded in the OLIF group. Conversely, postoperative neurological symptoms and psoas weakness were significatively more common in LLIF group.

Conclusions

The meta-analysis suggests that OLIF and LLIF are both effective for lumbar degenerative disorders, although each of them presents specific complications and this should represent a relevant element in the surgical planning.

Miscusi M, Carnevali C, Ricciardi L et al (2020) Histomorphology and immunohistochemical patterns in degenerative disc disease and clinical-radiological correlations: a prospective study. Eur Spine J. https://doi.org/10.1007/s00586-020-06412-9CrossRef

Ricciardi L, Stifano V, Sturiale CL et al (2020) Minimally invasive decompression with posterior elements preservation versus laminectomy and fusion for lumbar degenerative spondylolisthesis: a systematic review and meta-analysis of surgical, clinical and radiological outcomes. Surg Technol Int 36

Eck JC, Sharan A, Ghogawala Z et al (2014) Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 7: lumbar fusion for intractable low-back pain without stenosis or spondylolisthesis. J Neurosurg Spine 21:42–47. https://doi.org/10.3171/2014.4.SPINE14270CrossRef

Balagué F, Mannion AF, Pellisé F, Cedraschi C (2012) Non-specific low back pain. Lancet 379:482–491. https://doi.org/10.1016/S0140-6736(11)60610-7CrossRef

Bonaldi G, Brembilla C, Cianfoni A (2015) Minimally-invasive posterior lumbar stabilization for degenerative low back pain and sciatica. A review. Eur J Radiol 84:789–798. https://doi.org/10.1016/j.ejrad.2014.04.012CrossRef

Miscusi M, Polli FM, Forcato S et al (2015) Comparison of minimally invasive surgery with standard open surgery for vertebral thoracic metastases causing acute myelopathy in patients with short- or mid-term life expectancy: surgical technique and early clinical results. J Neurosurg Spine 22:518–525. https://doi.org/10.3171/2014.10.SPINE131201CrossRef

Chu JK, Rindler RS, Pradilla G et al (2017) Percutaneous instrumentation without arthrodesis for thoracolumbar flexion-distraction injuries: a review of the literature. Neurosurgery 80:171–179. https://doi.org/10.1093/neuros/nyw056CrossRef

Imada AO, Huynh TR, Drazin D (2017) Minimally invasive versus open laminectomy/discectomy, transforaminal lumbar, and posterior lumbar interbody fusions: a systematic review. Cureus 9:e1488. https://doi.org/10.7759/cureus.1488CrossRef

Ahmed SI, Javed G, Bareeqa SB et al (2018) Comparison of decompression alone versus decompression with fusion for stenotic lumbar spine: a systematic review and meta-analysis. Cureus 10:e3135. https://doi.org/10.7759/cureus.3135CrossRef

10.

Brodano GB, Martikos K, Lolli F et al (2015) Transforaminal lumbar interbody fusion in degenerative disk disease and spondylolisthesis grade I: minimally invasive versus open surgery. J Spinal Disord Tech 28:E559-564. https://doi.org/10.1097/BSD.0000000000000034CrossRef

11.

Dijkerman ML, Overdevest GM, Moojen WA, Vleggeert-Lankamp CLA (2018) Decompression with or without concomitant fusion in lumbar stenosis due to degenerative spondylolisthesis: a systematic review. Eur Spine J 27:1629–1643. https://doi.org/10.1007/s00586-017-5436-5CrossRef

12.

Försth P, Ólafsson G, Carlsson T et al (2016) A randomized, controlled trial of fusion surgery for lumbar spinal stenosis. N Engl J Med 374:1413–1423. https://doi.org/10.1056/NEJMoa1513721CrossRef

13.

Ghogawala Z, Dziura J, Butler WE et al (2016) Laminectomy plus fusion versus laminectomy alone for lumbar spondylolisthesis. N Engl J Med 374:1424–1434. https://doi.org/10.1056/NEJMoa1508788CrossRef

14.

Ghiasi MS, Arjmand N, Shirazi-Adl A et al (2016) Cross-sectional area of human trunk paraspinal muscles before and after posterior lumbar surgery using magnetic resonance imaging. Eur Spine J 25:774–782. https://doi.org/10.1007/s00586-015-4014-yCrossRef

15.

Miscusi M, Serrao M, Conte C et al (2019) Spatial and temporal characteristics of the spine muscles activation during walking in patients with lumbar instability due to degenerative lumbar disk disease: evaluation in pre-surgical setting. Hum Mov Sci 66:371–382. https://doi.org/10.1016/j.humov.2019.05.013CrossRef

16.

Akinduro OO, Miller BA, Haussen DC et al (2015) Complications of intraoperative epidural steroid use in lumbar discectomy: a systematic review and meta-analysis. Neurosurg Focus 39:E12. https://doi.org/10.3171/2015.7.FOCUS15269CrossRef

17.

Miscusi M, Polli FM, Forcato S et al (2014) The use of surgical sealants in the repair of dural tears during non-instrumented spinal surgery. Eur Spine J 23:1761–1766. https://doi.org/10.1007/s00586-013-3138-1CrossRef

18.

Carreon LY, Puno RM, Dimar JR et al (2003) Perioperative complications of posterior lumbar decompression and arthrodesis in older adults. J Bone Joint Surg Am 85:2089–2092. https://doi.org/10.2106/00004623-200311000-00004CrossRef

19.

Zanirato A, Damilano M, Formica M et al (2018) Complications in adult spine deformity surgery: a systematic review of the recent literature with reporting of aggregated incidences. Eur Spine J. https://doi.org/10.1007/s00586-018-5535-yCrossRef

20.

Fantoni M, Trecarichi EM, Rossi B et al (2012) Epidemiological and clinical features of pyogenic spondylodiscitis. Eur Rev Med Pharmacol Sci 16(Suppl 2):2–7

21.

Lau D, Clark AJ, Scheer JK et al (2014) Proximal junctional kyphosis and failure after spinal deformity surgery: a systematic review of the literature as a background to classification development. Spine 39:2093–2102. https://doi.org/10.1097/BRS.0000000000000627CrossRef

22.

Bassani R, Querenghi AM, Cecchinato R et al (2018) A new “keyhole” approach for multilevel anterior lumbar interbody fusion: the perinavel approach-technical note and literature review. Eur Spine J 27:1956–1963. https://doi.org/10.1007/s00586-018-5659-0CrossRef

23.

Orita S, Shiga Y, Inage K et al (2021) Technical and conceptual review on the L5–S1 oblique lateral interbody fusion surgery (OLIF51). Spine Surg Relat Res 5:1–9. https://doi.org/10.22603/ssrr.2020-0086CrossRef

24.

Miscusi M, Trungu S, Ricciardi L et al (2020) The anterior-to-psoas approach for interbody fusion at the L5–S1 segment: clinical and radiological outcomes. Neurosurg Focus 49:E14. https://doi.org/10.3171/2020.6.FOCUS20335CrossRef

25.

Ozgur BM, Aryan HE, Pimenta L, Taylor WR (2006) Extreme Lateral Interbody Fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion. Spine J 6:435–443. https://doi.org/10.1016/j.spinee.2005.08.012CrossRef

26.

Pelletier Y, Lareyre F, Cointat C, Raffort J (2021) Management of vascular complications during anterior lumbar spinal surgery using mini-open retroperitoneal approach. Ann Vasc Surg. https://doi.org/10.1016/j.avsg.2021.01.077CrossRef

27.

Miscusi M, Ramieri A, Forcato S et al (2018) Comparison of pure lateral and oblique lateral inter-body fusion for treatment of lumbar degenerative disk disease: a multicentric cohort study. Eur Spine J 27:222–228. https://doi.org/10.1007/s00586-018-5596-yCrossRef

28.

Barone G, Scaramuzzo L, Zagra A et al (2017) Adult spinal deformity: effectiveness of interbody lordotic cages to restore disc angle and spino-pelvic parameters through completely mini-invasive trans-psoas and hybrid approach. Eur Spine J 26:457–463. https://doi.org/10.1007/s00586-017-5136-1CrossRef

29.

Ricciardi L, Stifano V, Proietti L et al (2018) Intraoperative and postoperative segmental lordosis mismatch: analysis of 3 fusion techniques. World Neurosurg 115:e659–e663. https://doi.org/10.1016/j.wneu.2018.04.126CrossRef

30.

Tamburrelli FC, Meluzio MC, Burrofato A et al (2018) Minimally invasive surgery procedure in isthmic spondylolisthesis. Eur Spine J. https://doi.org/10.1007/s00586-018-5627-8CrossRef

31.

Berjano P, Lamartina C (2013) Far lateral approaches (XLIF) in adult scoliosis. Eur Spine J 22(Suppl 2):S242-253. https://doi.org/10.1007/s00586-012-2426-5CrossRef

32.

Moher D, Liberati A, Tetzlaff J et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097. https://doi.org/10.1371/journal.pmed.1000097CrossRef

33.

DerSimonian R, Kacker R (2007) Random-effects model for meta-analysis of clinical trials: an update. Contemp Clin Trials 28:105–114. https://doi.org/10.1016/j.cct.2006.04.004CrossRef

34.

Li J, Wang X, Sun Y et al (2019) Safety analysis of two anterior lateral lumbar interbody fusions at the initial stage of learning curve. World Neurosurg 127:e901–e909. https://doi.org/10.1016/j.wneu.2019.03.294CrossRef

35.

Ko MJ, Park SW, Kim YB (2019) Effect of cage in radiological differences between direct and oblique lateral interbody fusion techniques. J Korean Neurosurg Soc 62:432–441. https://doi.org/10.3340/jkns.2018.0142CrossRef

36.

Proietti L, Perna A, Ricciardi L et al (2020) Radiological evaluation of fusion patterns after lateral lumbar interbody fusion: institutional case series. Radiol Med. https://doi.org/10.1007/s11547-020-01252-5CrossRef

37.

Lenz M, Mohamud K, Bredow J et al (2021) Comparison of different approaches in lumbosacral spinal fusion surgery: a systematic review and meta-analysis. Asian Spine J. https://doi.org/10.31616/asj.2020.0405CrossRef

38.

Ricciardi L, Sturiale CL, Pucci R et al (2019) Patient-oriented aesthetic outcome after lumbar spine surgery: a 1-year follow-up prospective observational study comparing minimally invasive and standard open procedures. World Neurosurg 122:e1041–e1046. https://doi.org/10.1016/j.wneu.2018.10.208CrossRef

39.

Eun I-S, Son SM, Goh TS, Lee JS (2020) Sagittal spinopelvic alignment after spinal fusion in degenerative lumbar scoliosis: a meta-analysis. Br J Neurosurg 34:176–180. https://doi.org/10.1080/02688697.2020.1725437CrossRef

40.

Tang L, Wu Y, Jing D et al (2020) A Bayesian network meta-analysis of 5 different fusion surgical procedures for the treatment of lumbar spondylolisthesis. Medicine (Baltimore) 99:e19639. https://doi.org/10.1097/MD.0000000000019639CrossRef

41.

Chi K-Y, Cheng S-H, Kuo Y-K et al (2021) Safety of lumbar interbody fusion procedures for degenerative disc disease: a systematic review with network meta-analysis of prospective studies. Global Spine J 11:751–760. https://doi.org/10.1177/2192568220938024CrossRef

42.

Mu X, Yu C, Wang C et al (2021) Comparison of extreme lateral approach with posterior approach in the treatment of lumbar degenerative diseases: a meta-analysis of clinical and imaging findings. Surgeon 19:268–278. https://doi.org/10.1016/j.surge.2020.08.002CrossRef

Titel: Lumbar interbody fusion using oblique (OLIF) and lateral (LLIF) approaches for degenerative spine disorders: a meta-analysis of the comparative studies
verfasst von: Luca Ricciardi
Amedeo Piazza
Mattia Capobianco
Giuseppe Maria Della Pepa
Massimo Miscusi
Antonino Raco
Alba Scerrati
Teresa Somma
Giorgio Lofrese
Carmelo Lucio Sturiale
Publikationsdatum: 26.11.2021
Verlag: Springer Paris
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 1/2023
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-021-03172-0

Correction to: Comparison of fibula strut and calcium phosphate cement augmentation of the medial buttress in 2-part proximal humerus fractures reconstruction: a biomechanical study

Correction

The reuse of circular external fixator components: an assessment of safety and potential savings

Original Article

Is magnetic resonance imaging needed for decision making diagnosis and treatment of thoracic and lumbar vertebral fractures?

Original Article

How does corrective fusion surgery for adult spinal deformities affect pelvic inclination in the supine position as the reference plane for THA?

Original Article

Distal third clavicle fractures treated with anatomical locking plates with or without coraco-clavicular ligament augmentation: why not an intraoperative decision?

Letter to the Editor

Are pre- and postoperative true translational and angular displacement predictive of nonunion after intramedullary nail fixation of tibial shaft fractures?

Original Article

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie erweitert durch Fallbeispiele, Videos und Abbildungen. Zur Fortbildung und Wissenserweiterung, verfasst und geprüft von Expertinnen und Experten der Gesellschaft für Arthroskopie und Gelenkchirurgie (AGA).

Jetzt entdecken!

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Was sich Menschen mit Frozen Shoulder wünschen

10.01.2025
Schultersteife
Nachrichten

Die Capsulitis adhaesiva des Glenohumeralgelenks, auch als Frozen Shoulder bezeichnet, belastet die Betroffenen weit über die körperlichen Beschwerden hinaus, wie eine italienische Studie ergeben hat.

Restriktive Sauerstoffgabe ohne Vorteil bei schwerem Trauma

09.01.2025
Traumatologische Notfallmedizin
Nachrichten

Ob schwer verletzte Personen besser restriktiv oder liberal mit Sauerstoff versorgt werden sollten, hat die Arbeitsgruppe der TRAUMOX2-Studie untersucht – mit klarem Ergebnis.

Hinweis auf Zusatznutzen der Anfallsprophylaxe mit Colchicin

08.01.2025
Hyperurikämie und Gicht
Nachrichten

Wenn Gichtkranke in den ersten Monaten einer harnsäuresenkenden Therapie eine Anfallsprophylaxe mit Colchicin erhalten, könnten sie davon doppelt profitieren: Ihr Risiko für kardiovaskuläre Komplikationen scheint ebenfalls gesenkt zu werden.

Wenn orthopädische Patienten psychiatrische Hilfe brauchen

20.12.2024
Behandlungsmethoden
Nachrichten

Auch in der orthopädischen Praxis ist man manchmal mit psychischen Problemen konfrontiert. Woran Sie erkennen können, ob Ihre Patientin oder Ihr Patient eigentlich die Hilfe einer anderen Fachdisziplin benötigt, hat ein Team aus Bologna zusammengefasst.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Lumbar interbody fusion using oblique (OLIF) and lateral (LLIF) approaches for degenerative spine disorders: a meta-analysis of the comparative studies