Clinical Outcome of Extended Oblique Lateral Interbody Fusion for Thoracic and Thoracolumbar Spinal Disorders

Presented at SMISS Annual Forum 2016
By Takuma Kaibara
With Yoshihisa Kotani MD, PhD, Katsuhisa Fujita, Yusuke Kameda, Hideaki Fukaya

Disclosures: Takuma Kaibara None, Yoshihisa Kotani MD, PhD None, Katsuhisa Fujita None, Yusuke Kameda None, Hideaki Fukaya None

Introduction

We have experienced more than 150 cases of OLIF surgeries since 2012. The OLIF surgery has been widely used
for lumbar interbody fusion, however, the safety and efficacy
of extended application for thoracic and thoracolumbar lesions
are still unclear. 

Aims/Objectives

The purpose of this study was to evaluate clinical outcome of extended OLIF for thoracic and thoracolumbar lesions above T12/L1 level. 

Methods

Since September 2012, twenty patients received OLIF surgeries above T12/L1 level. There were 7 male and 13 female
with the mean age of 69 years old (range:47-84). The spinal disorders included burst fracture, kyphoscoliosis, spondylitis, tumor, disc herniation, proximal junctional kyphosis and etc. The surgeries included segmental OLIF in 15, corpectomy in 4, and anterior osteotomy in 1. The surgical time, estimated blood loss, fusion rate and complications were evaluated. 

Results

Mean number of segments fixed was three (range:1-6). Mean surgical time and estimated blood loss were 348 minutes and 366ml, respectively. The surgical approaches were extrapleural in 15, transthoracic in 4, and retroperitoneal in 1 case. We needed to convert approach from extrapleural to transthoracic in 2 cases (13%). The complications of pleural damage were seen in 3 cases requiring chest tube. There were no other complications such as infection, neurological deficit and vascular injury. All patients led to successful fusion. 

Conclusions

The clinical results of extended OLIF for thoracic and thoracolumbar disorders were satisfactory without major complications. These techniques were useful for spinal canal decompression and anterior circumferential osteotomy with minimized open anterior technique. The complications related to pleural or diaphragm injury seemed to be less compared to conventional open surgery, thereby being beneficial for elderly
and generally compromised patients.