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Original article
peer-reviewed

Oblique Lateral Lumbar Interbody Fusion (OLLIF): Technical Notes and Early Results of a Single Surgeon Comparative Study



Abstract

Background context: Lower back pain is one of the most prevalent and expensive health conditions in the Western world. The standard treatment, interbody fusion, is an invasive procedure that requires the stripping of muscles and soft tissue, leading to surgical morbidity. Current minimally invasive (MI) spinal fusions are technically demanding and suffer from technical limitations.

Purpose: Oblique lumbar lateral interbody fusion (OLLIF) is a new technique for fusion of the lumbar spine that overcomes these complications. Outcome measures include patient demographics, reported outcomes, and surgical outcomes.

Study design/Setting: Kambin's Triangle can easily be located as a silent window with an electrophysiological probe. Discectomy is performed through a single access portal with a 10 mm diameter. After a discectomy, the disc space is packed with beta-tricalcium phosphate soaked in autologous bone marrow, aspirated, and the cage is inserted. Finally, a minimally invasive posterior fixation is performed.

Methods: OLLIF’s major innovation is to approach the disc through Kambin’s Triangle, aided by bilateral fluoroscopy.

Results: We present data from 69 consecutive OLLIF surgeries on 128 levels with a control group of 55 consecutive open transformational lumbar interbody fusions (TLIFs) on 125 levels. For a single level OLLIF, the mean surgery time is 69 minutes (min) and blood loss is 29 ml. Surgery time was approximately twice as fast as open TLIF (mean: 135 min) and blood loss is reduced by over 80% compared to TLIF (mean: 355 ml).

Conclusions: OLLIF is a minimally invasive fusion that significantly reduces surgery times compared to open surgery. OLLIF overcomes the difficulties of traditional open fusions, making it a safe and technically less demanding surgery than open or minimally invasive TLIF. 



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Original article
peer-reviewed

Oblique Lateral Lumbar Interbody Fusion (OLLIF): Technical Notes and Early Results of a Single Surgeon Comparative Study


Author Information

Hamid Abbasi

Tristate Brain and Spine Institute

Ali Abbasi Corresponding Author

Trinity College, University of Cambridge


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Pearl Institutional Review Board issued approval There was an IRB exemption provided for this study. The exception number is 15-TRI-101. An IRB exception was granted. This study was conducted through a retrospective research and analysis of participating patients' electronic medical records. The exempt status of this study in accordance with FDA 21 CFR 56.104 and DHHS 45 CFR 46.101 regulations was approved by the Pearl Institutional Review Board (Indianapolis, IN 46260) in February 2015. Animal subjects: This study did not involve animal subjects or tissue. Conflicts of interest: The authors have declared that no conflicts of interest exist.


Original article
peer-reviewed

Oblique Lateral Lumbar Interbody Fusion (OLLIF): Technical Notes and Early Results of a Single Surgeon Comparative Study


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Original article
peer-reviewed

Oblique Lateral Lumbar Interbody Fusion (OLLIF): Technical Notes and Early Results of a Single Surgeon Comparative Study

  • Author Information
    Hamid Abbasi

    Tristate Brain and Spine Institute

    Ali Abbasi Corresponding Author

    Trinity College, University of Cambridge


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Pearl Institutional Review Board issued approval There was an IRB exemption provided for this study. The exception number is 15-TRI-101. An IRB exception was granted. This study was conducted through a retrospective research and analysis of participating patients' electronic medical records. The exempt status of this study in accordance with FDA 21 CFR 56.104 and DHHS 45 CFR 46.101 regulations was approved by the Pearl Institutional Review Board (Indianapolis, IN 46260) in February 2015. Animal subjects: This study did not involve animal subjects or tissue. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements


    Article Information

    Published: October 15, 2015

    DOI

    10.7759/cureus.351

    Cite this article as:

    Abbasi H, Abbasi A (October 15, 2015) Oblique Lateral Lumbar Interbody Fusion (OLLIF): Technical Notes and Early Results of a Single Surgeon Comparative Study . Cureus 7(10): e351. doi:10.7759/cureus.351

    Publication history

    Received by Cureus: September 25, 2015
    Peer review began: October 03, 2015
    Peer review concluded: October 07, 2015
    Published: October 15, 2015

    Copyright

    © Copyright 2015
    Abbasi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background context: Lower back pain is one of the most prevalent and expensive health conditions in the Western world. The standard treatment, interbody fusion, is an invasive procedure that requires the stripping of muscles and soft tissue, leading to surgical morbidity. Current minimally invasive (MI) spinal fusions are technically demanding and suffer from technical limitations.

Purpose: Oblique lumbar lateral interbody fusion (OLLIF) is a new technique for fusion of the lumbar spine that overcomes these complications. Outcome measures include patient demographics, reported outcomes, and surgical outcomes.

Study design/Setting: Kambin's Triangle can easily be located as a silent window with an electrophysiological probe. Discectomy is performed through a single access portal with a 10 mm diameter. After a discectomy, the disc space is packed with beta-tricalcium phosphate soaked in autologous bone marrow, aspirated, and the cage is inserted. Finally, a minimally invasive posterior fixation is performed.

Methods: OLLIF’s major innovation is to approach the disc through Kambin’s Triangle, aided by bilateral fluoroscopy.

Results: We present data from 69 consecutive OLLIF surgeries on 128 levels with a control group of 55 consecutive open transformational lumbar interbody fusions (TLIFs) on 125 levels. For a single level OLLIF, the mean surgery time is 69 minutes (min) and blood loss is 29 ml. Surgery time was approximately twice as fast as open TLIF (mean: 135 min) and blood loss is reduced by over 80% compared to TLIF (mean: 355 ml).

Conclusions: OLLIF is a minimally invasive fusion that significantly reduces surgery times compared to open surgery. OLLIF overcomes the difficulties of traditional open fusions, making it a safe and technically less demanding surgery than open or minimally invasive TLIF. 



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Hamid Abbasi

Tristate Brain and Spine Institute

Ali Abbasi, Medical Student

Trinity College, University of Cambridge

For correspondence:
biotechdir@gmail.com

Hamid Abbasi

Tristate Brain and Spine Institute

Ali Abbasi, Medical Student

Trinity College, University of Cambridge

For correspondence:
biotechdir@gmail.com