Research Article: Combined oblique lateral interbody fusion and spinal endoscopy (Endo-OLIF) for degenerative lumbar disease: early clinical outcomes of a novel minimally invasive approach
Abstract:
The combination of oblique lumbar interbody fusion (OLIF) and spinal endoscopy presents a promising minimally invasive approach for treating degenerative lumbar diseases, leveraging the strengths of both techniques to optimize clinical outcomes. We term this combined technique Endo-OLIF (endoscopy-assisted oblique lumbar interbody fusion).
This study aimed to evaluate the early clinical efficacy and technical nuances of Endo-OLIF in the management of degenerative lumbar conditions.
A retrospective analysis was conducted on 29 patients who underwent Endo-OLIF for degenerative lumbar diseases at our institution between February 2022 and November 2023. Inclusion criteria specified treatment of no more than two contiguous levels between L2 and L5. Patients with left-sided disc herniation or predominant left-sided stenosis were excluded due to technical considerations of the endoscopic working trajectory. Clinical outcomes were assessed using the visual analogue scale (VAS) for pain and the Oswestry Disability Index (ODI) for functional disability. The mean follow-up duration was 15.6 months (range 12–22 months).
All procedures were successfully completed without intraoperative complications such as nerve root injury or dural sac injury. Postoperatively, two patients (6.9%) experienced transient ipsilateral thigh numbness or hip flexion weakness, which we attribute to intraoperative retraction and blunt stimulation of the lumbar plexus; both resolved completely within 6 weeks without specific intervention. Postoperative imaging confirmed satisfactory interbody fusion and complete removal of herniated disc material. Significant improvements in VAS and ODI scores were observed at 3 months postoperatively and maintained at final follow-up (mean 15.6 months) ( P <?0.05 for all comparisons). The mean VAS scores for back pain improved from 7.1?±?1.3 preoperatively to 1.6?±?0.7 at final follow-up; leg pain VAS improved from 6.3?±?1.2 to 1.3?±?0.5; ODI improved from 66.8?±?9.7 to 12.6?±?7.1. Patients reported high satisfaction levels, short recovery times, and no serious postoperative complications.
Endo-OLIF capitalizes on the advantages of both minimally invasive approaches: OLIF preserves the posterior ligamentous complex and avoids nerve root irritation, while spinal endoscopy allows direct decompression by removing herniated disc material. This combined approach demonstrates favorable short-term outcomes with significant improvements in pain and functional disability scores. However, long-term efficacy requires further follow-up studies.
Introduction:
The combination of oblique lumbar interbody fusion (OLIF) and spinal endoscopy presents a promising minimally invasive approach for treating degenerative lumbar diseases, leveraging the strengths of both techniques to optimize clinical outcomes. We term this combined technique Endo-OLIF (endoscopy-assisted oblique lumbar interbody fusion).
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