Treatment of Single Level Lumbar Spondylolisthesis with Lumbar Interbody Fusion via Oblique Lateral Approach (OLIF)

Abstract

Objectives: To investigate the effect of lumbar interbody fusion via the oblique lateral approach (OLIF) in the treatment of single level lumbar spondylolisthesis. Methods : Retrospective analysis was made on 32 cases of single level lumbar spondylolisthesis treated by lumbar interbody fusion via the oblique lateral approach from July 2020 to July 2021. 14 males and 18 females; the age was (66.5 ± 11.5) years (55 - 82 years). 1) The operation time, intraoperative blood loss and complications were recorded; 2) the scores of visual analog scale. VAS and Oswestry disability index (ODI) of low back pain and lower limb pain were collected before operation and at the last follow-up; by ob serving the imaging data, the height of the intervertebral space, the anterior convex angle of the intervertebral space, the anterior convex angle of the lumbar spine, the sagittal diameter of the dural sac and the spondylolisthesis were measured. Results: All patients successfully completed the operation, the av erage operation time was (103.9 ± 21.1) min, the average intraoperative bleeding volume was (72.3 ± 16.4) ml. There was no vascular injury during the operation, no infection occurred in all surgical incisions, and Class I/A healing was achieved. The VAS scores of low back pain and leg pain before operation and at the last follow-up were lower than those before operation, and the difference was statistically significant (P < 0.05); the ODI at the last follow-up was lower than that before operation, and the difference was statistically significant (P < 0.05). At the last follow-up, the height of intervertebral space, the height of intervertebral foramen and the sagittal diameter of dural sac were greater than those before operation, with statistically significant differences (P < 0.05); the spondylolisthesis rate at the last follow-up was lower than that before operation, with a statistically significant difference (P < 0.05). Left thigh surface numbness occurred in 2 cases (6.3%) and disappeared after 1 week; Hip flexion weakness occurred in 1 case (0.03%), which recovered after 12 days; there were no complications such as retroperitoneal hematoma, ureteral injury, retrograde ejaculation, intestinal and lumbar plexus injury. Conclusion: The early clinical effect of OLIF in the treatment of single level lumbar spondylolisthesis is significant. This surgical method is minimally invasive, safe and effective, which can significantly reduce the amount of intra operative bleeding and reduce the risk of postoperative complications. Its main working principle is to make the annulus fibrosus, posterior longitudinal ligament and ligamentum flavum shrink and recover the height of the in tervertebral space through decompression, loosening and stretching of the intervertebral space, so as to achieve the reduction of the slipped vertebral body, increase the height of the intervertebral foramen Enlarge the spinal canal volume and eliminate dynamic compression to play an indirect decompression role, improve the symptoms of low back and leg pain, and reconstruct the stability of the spine through interbody fusion.