Feasibility of Ipsilateral Revision Oblique Lateral Interbody Fusion for Adjacent Segment Disease After Primary Oblique Lateral Interbody Fusion: A Retrospective Case Series

TL;DR

This study shows that a second oblique lateral spine surgery can effectively treat complications after the first surgery, with good results and few complications.

Contribution

This is the first study to evaluate the feasibility of re-OLIF for adjacent segment disease following primary OLIF.

Findings

Re-OLIF was successfully performed in all six patients with no significant complications.

Clinical outcomes improved significantly after re-OLIF, with reduced pain and increased function scores.

Operative time and blood loss were comparable between re-OLIF and primary OLIF procedures.

Abstract

Background: Oblique lateral interbody fusion (OLIF) is a minimally invasive procedure widely used to treat various lumbar spinal disorders. Although OLIF is an effective salvage procedure for adjacent segment disease (ASD) after transforaminal lumbar interbody fusion (TLIF) or posterior lumbar interbody fusion (PLIF), the feasibility of revision OLIF (re-OLIF) for ASD after primary OLIF remains unclear. We aimed to evaluate the feasibility and outcomes of re-OLIF in patients with ASD after primary OLIF.

Materials and methods: This retrospective case series included patients who underwent OLIF at our hospital between 2012 and 2023, developed ASD postoperatively, and subsequently underwent re-OLIF with at least 12 months of follow-up. Clinical data, including operative details, intraoperative blood loss, perioperative complications, and clinical outcomes such as visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) scores, were collected and analyzed.

Results: Six patients underwent re-OLIF for ASD following primary OLIF. Re-OLIF was successfully performed in all cases with no significant complications or difficulties. Operative time and intraoperative blood loss were comparable between the re-OLIF and primary OLIF groups. Clinical outcomes improved significantly after re-OLIF, with VAS scores decreasing from a median of 7.5 to 2.0 and JOA scores increasing from a median of 15.5 to 21.0.

Conclusions: Re-OLIF can be a safe and effective salvage procedure for ASD after primary OLIF, with outcomes comparable to those of primary OLIF. Given the increasing number of OLIF procedures performed, further studies with larger sample sizes are necessary to confirm the long-term safety and efficacy of re-OLIF as a salvage option for ASD.

Figures