Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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A Comprehensive Analysis of Potential Complications after Oblique Lumbar Interbody Fusion : A Review of Postoperative Magnetic Resonance Scans in Over 400 Cases

  • Kang-Hoon Lee (Department of Neurosurgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital) ;
  • Su-Hun Lee (Department of Neurosurgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital) ;
  • Jun-Seok Lee (Department of Neurosurgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital) ;
  • Young-Ha Kim (Department of Neurosurgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital) ;
  • Soon-Ki Sung (Department of Neurosurgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital) ;
  • Dong-Wuk Son (Department of Neurosurgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital) ;
  • Sang-Weon Lee (Department of Neurosurgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital) ;
  • Geun-Sung Song (Department of Neurosurgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital)
  • Received : 2023.12.01
  • Accepted : 2024.02.13
  • Published : 2024.09.01
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Abstract

Objective : This study focuses on identifying potential complications following oblique lumbar interbody fusion (OLIF) through routine magnetic resonance (MR) scans. Methods : From 650 patients who underwent OLIF from April 2018 to April 2022, this study included those with MR scans taken 1-week post-operatively, and only for indirect decompression patients. The analysis evaluated postoperative MR images for hematoma, cage insertion angles, and indirect decompression efficiency. Patient demographics, post-operatively symptoms, and complications were also evaluated. Results : Out of 401 patients enrolled, most underwent 1- or 2-level OLIF. Common findings included approach site hematoma (65.3%) and contralateral psoas hematoma (19%). The caudal level OLIF was related with less orthogonality and deep insertion of cage. Incomplete indirect decompression occurred in 4.66% of cases but did not require additional surgery. Rare but symptomatic complications included remnant disc rupture (four cases, 1%) and synovial cyst rupture (four cases, 1%). Conclusion : This study has identified potential complications associated with OLIF, including approach site hematoma, contralateral psoas hematoma, cage malposition risk at caudal levels, and radiologically insufficient indirect decompression. Additionally, it highlights rare, yet symptomatic complications such as remnant disc rupture and synovial cyst rupture. These findings contribute insights into the relatively under-explored area of OLIF complications.

Keywords

Acknowledgement

This study was supported by Research institute for Convergence of biomedical science and technology (30-2023-006), Pusan National University Yangsan Hospital.

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