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KMID : 1189320120060020089
Asian Spine Journal
2012 Volume.6 No. 2 p.89 ~ p.97
Complications and Morbidities of Mini-open Anterior Retroperitoneal Lumbar Interbody Fusion: Oblique Lumbar Interbody Fusion in 179 Patients
Silvestre Clement

Mac Thiong Jean Marc
Hilmi Radwan
Roussouly Pierre
Abstract
Study Design: A retrospective study including 179 patients who underwent oblique lumbar interbody fusion (OLIF) at one institution.

Purpose: To report the complications associated with a minimally invasive technique of a retroperitoneal anterolateral approach to the lumbar spine.

Overview of Literature: Different approaches to the lumbar spine have been proposed, but they are associated with an increased risk of complications and a longer operation.

Methods: A total of 179 patients with previous posterior instrumented fusion undergoing OLIF were included. The technique is described in terms of: the number of levels fused, operative time and blood loss. Persurgical and postsurgical complications were noted.

Results: Patients were age 54.1 ¡¾ 10.6 with a BMI of 24.8 ¡¾ 4.1 kg/m2. The procedure was performed in the lumbar spine at L1-L2 in 4, L2-L3 in 54, L3-L4 in 120, L4-L5 in 134, and L5-S1 in 6 patients. It was done at 1 level in 56, 2 levels in 107, and 3 levels in 16 patients. Surgery time and blood loss were, respectively, 32.5 ¡¾ 13.2 minutes and 57 ¡¾ 131 ml per level fused. There were 19 patients with a single complication and one with two complications, including two patients with postoperative radiculopathy after L3-5 OLIF. There was no abdominal weakness or herniation.

Conclusions: Minimally invasive OLIF can be performed easily and safely in the lumbar spine from L2 to L5, and at L1-2 for selected cases. Up to 3 levels can be addressed through a 'sliding window'. It is associated with minimal blood loss and short operations, and with decreased risk of abdominal wall weakness or herniation.
KEYWORD
Anterior approach, Interbody fusion, Lumbar spine, Minimally invasive surgery
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