Short-term outcome of lumbosacral lordotic angle acquired using oblique lateral lumbosacral fusion (OLIF51) technique brought by two different intervertebral cages — The International Society for the Study of the Lumbar Spine
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Short-term outcome of lumbosacral lordotic angle acquired using oblique lateral lumbosacral fusion (OLIF51) technique brought by two different intervertebral cages (#1221)

Sumihisa Orita 1 , Kazuhide Inage 2 , Yasuhiro Shiga 2 , Yawara Eguchi 2 , Takashi Hozumi 2 , Geundong Kim 2 , Takuma Otagiri 2 , Tomohito Mukaihata 2 , Takahito Arai 2 , Noriyasu Toshi 2 , Satoshi Maki 2 , Takeo Furuya 2 , Seiji Ohtori 2
  1. Center for Frontier Medical Engineering / Department of Orthopaedic Surgery, Chiba University, Chiba, Japan
  2. Orhopaedic surgery, Graduate school of Medicine, Chiba University, Chiba, Japan

Background

Oblique lateral interbody fusion for L5/S lumbosacral junction (OLIF51) is one of the viable options for degenerative spine and/or discopathy at the level to provide significant postoperative results and reduced loss of correction of the lumbosacral vertebral angle in conjunction with bony fusion. However, the acquired lordosis angle can be different due to the intervertebral cage: general-purpose titanium cage for anterior interbody fusion (ALIF; Teijin Nakashima Medical minalif®) with a slight kyphosis angle of 6˚, that can be undersized/angled, resulting in the correction loss and cage subsidence. Another PEEK cage for OLIF51 (Medtronic Sovereign®), introduced to Japan in 2019, has a kyphosis of 8˚ to 14˚, which is more adaptable to the intervertebral space. The purpose of this study was to compare the change in correction angle of lumbosacral intervertebral fusion by using different cages.

Materials and Methods

In the present study, 15 patients (mean age 68.3 years, six males and nine females) underwent an anterior lumbosacral fusion with OLIF51 for lumbosacral diseases (lumbosacral spondylolisthesis, degenerative lumbar spondylolisthesis, etc.). We compared the intervertebral angle, correction rate of the L5/S intervertebral space, and presence of subsidence (more than 1 mm to the adjacent endplate) for each intervertebral cage. The significance level of the p-value was set at 0.05 for statistical examination.

Results

The mean kyphosis angle was 6° and 12.3±2.9°, and the mean cage height was 9.14±1.1 mm and 11.3±1.6 mm, respectively. The L5/S intervertebral kyphosis was 4.2˚/16.8˚ immediately after surgery (M group/S group, same as below). One patient in the M group underwent additional posterior decompression due to postoperative leg pain, but no additional surgery was performed in the S group, and no intraoperative complications were observed.

There was no additional surgery in the S group, and there were no intraoperative complications. Eight (80%)/1 (20%) patients had postoperative subsidence, and in the M group, subsidence at the cephalic endplate was significantly observed with one case with mild anterior backout of the cage.

Conclusion: Minimally invasive lumbosacral anterior fusion OLIF51 with a dedicated kyphosis cage provides relatively good kyphosis correction and significantly reduces subsidence and correction loss compared with a general ALIF cage.

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