Salvage Oblique Lateral Interbody Fusion for Pseudarthrosis after Posterior/Transforaminal Lumbar Interbody Fusion: A Technical Note

World Neurosurg. 2021 Aug:152:107-112. doi: 10.1016/j.wneu.2021.06.020. Epub 2021 Jun 12.

Abstract

Objective: This study aims to demonstrate the efficacy of salvage oblique lumbar interbody fusion (OLIF) surgery for pseudarthrosis after posterior/transforaminal lumbar interbody fusion (PLIF/TLIF).

Methods: The study group were patients with leg or back pain induced by pseudarthrosis after PLIF/TLIF. These patients underwent salvage OLIF surgeries in our institutions between July 2015 and Oct 2019. We retrospectively evaluated their clinical and radiographic outcomes.

Results: Seven consecutive patients (all male; mean age 68.4 ± 9.3 years, range 53-81 years) were included in this study. There was no intraoperative complications in all cases. Six of 7 patients achieved bone union (at average 33.4 months follow-up) and had a successful postoperative course. Only 1 patient failed to gain bony fusion and required additional revision surgery due to progression of sagittal and coronal malalignment at 18 months after salvage OLIF surgery.

Conclusions: The salvage OLIF approach was useful option for pseudarthrosis after PLIF/TLIF. It enabled us to build a rigid anterior support, allowed for extensive curettage of intervertebral scar tissue, and reduced the rate of the complications associated with dealing with posterior scar tissue.

Keywords: Nonunion; OLIF; Oblique lumbar interbody fusion; Pseudarthrosis; Salvage.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Lumbar Vertebrae
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery*
  • Pseudarthrosis / etiology*
  • Pseudarthrosis / surgery*
  • Salvage Therapy / methods
  • Spinal Fusion / adverse effects*
  • Spinal Fusion / methods*