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http://dx.doi.org/10.3340/jkns.2020.0342

Learning Curve and Complications Experience of Oblique Lateral Interbody Fusion : A Single-Center 143 Consecutive Cases  

Oh, Bu Kwang (Department of Neurosurgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital)
Son, Dong Wuk (Department of Neurosurgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital)
Lee, Su Hun (Department of Neurosurgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital)
Lee, Jun Seok (Department of Neurosurgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital)
Sung, Soon Ki (Department of Neurosurgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital)
Lee, Sang Weon (Department of Neurosurgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital)
Song, Geun Sung (Department of Neurosurgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital)
Publication Information
Journal of Korean Neurosurgical Society / v.64, no.3, 2021 , pp. 447-459 More about this Journal
Abstract
Objective : Oblique lateral interbody fusion (OLIF) is becoming the preferred treatment for degenerative lumbar diseases. As beginners, we performed 143 surgeries over 19 months. In these consecutive cases, we analyzed the learning curve and reviewed the complications in our experience. Methods : This was a retrospective study; however, complications that were well known in the previous literature were strictly recorded prospectively. We followed up the changes in estimated blood loss (EBL), operation time, and transient psoas paresis according to case accumulation to analyze the learning curve. Results : Complication-free patients accounted for 43.6% (12.9%, early stage 70 patients and 74.3%, late stage 70 patients). The most common complication was transient psoas paresis (n=52). Most of these complications occurred in the early stages of learning. C-reactive protein normalization was delayed in seven patients (4.89%). The operation time showed a decreasing trend with the cases; however, EBL did not show any significant change. Notable operation-induced complications were cage malposition, vertebral body fracture, injury to the ureter, and injury to the lumbar vein. Conclusion : According to the learning curve, the operation time and psoas paresis decreased. It is important to select an appropriately sized cage along with clear dissection of the anterior border of the psoas muscle to prevent OLIF-specific complications.
Keywords
Intervertebral disc; Retroperitoneal space; Spinal fusion/adverse effect; Psoas muscle; Learning curve;
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