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How I do it? Oblique lumbar interbody fusion at L5S1(OLIF51)

  • How I Do it - Spine degenerative
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Abstract

Background

OLIF51 retains the advantages of traditional ALIF procedure with good fusion rates and improvement in radiographic parameters and reduces its drawbacks. It has the added advantage of being a minimal access technique.

Methods

Preoperative analysis of the vascular anatomy using CT angiography is mandatory. OLIF51 is done in right lateral position using specialized retractor blades and Thompson retractor system. The procedure is similar to OLIF at other levels except for the differences described here. The instruments are specialized for OLIF at L5S1.

Conclusion

OLIF51 provides an excellent alternative to traditional ALIF.

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, The Catholic University of Korea, Seoul St. Mary’s Hospital, 222, Banpo-daero, Seocho-gu, Seoul, South Korea

    Jin-Sung Kim & Sagar B. Sharma

Authors
  1. Jin-Sung Kim
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  2. Sagar B. Sharma
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Corresponding author

Correspondence to Jin-Sung Kim.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (name of institute/committee) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

Key points

i. OLIF51 provides an excellent alternative to ALIF as a minimally invasive option [4, 9, 10], retaining its advantages including sagittal balance correction and large fusion area [5]

ii. Careful evaluation of the vascular structures is essential for case selection

iii. Lateral positioning makes the abdominal contents move away from the surgical field making retraction easier. This translates into a lower chance of hypogastric plexus injury [7].

iv. The self-retaining retractor system is an indispensable component of the procedure

v. The iliohypogastric and ilioinguinal nerves should be safeguarded during exposure

vi. Bipolar cautery usage minimizes plexus injury near the disc

vii. The extent of discectomy can be aided by C-arm and Iobrix dye

viii. OLIF51 can be combined with OLIF25 for multilevel conditions

ix. Vascular injury is a conceivable and ghastly complication. Avoid at all costs.

x. Posterior instrumentation with pedicular screws should be supplemented for a better rigidity of the construct

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The authors declare that the article has not been submitted, in part or whole, elsewhere for review.

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This article is part of the Topical Collection on Spine degenerative

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Kim, JS., Sharma, S.B. How I do it? Oblique lumbar interbody fusion at L5S1(OLIF51). Acta Neurochir 161, 1079–1083 (2019). https://doi.org/10.1007/s00701-019-03918-0

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  • DOI: https://doi.org/10.1007/s00701-019-03918-0

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