Minimally Invasive Oblique Lateral Interbody Fusion for L4-5: Surgical Outcomes and Perioperative Complications

Abstract Purpose:Oblique lateral interbody fusion is increasingly being used by spine surgeons due to its many advantages. Although clinical analysis of oblique lateral interbody fusion has been assessed in many studies, surgical outcomes and perioperative complications of oblique lateral interbody fusion technique at L4-5 level have been rarely reported. The aim of this study is to investigate surgical outcomes and perioperative complications of oblique lateral interbody fusion for patients with degenerative disorders at L4-5, with it being the most common level of degenerative lumbar spine disease. Methods: Twenty-eight patients who underwent oblique lateral interbody fusion at L4-5 were enrolled. The numeric rating scale and Oswestry disability index score were used to assess clinical and functional outcomes. Radiological data included fusion rate, as well as measured changes in the disc and bilateral foramen height. Perioperative complications were also assessed. Results: The numeric rating scales for back and leg, and Oswestry disability index were significantly improved at postoperative 6-month, 1-year, and 2-year compared with preoperative condition (p < 0.05). The changes in the disc height, bilateral foramen height, and segmental lordotic angle between the preoperative and postoperative periods were significant (p < 0.05). Disc heights at postoperative 6 months, 1 year, and 2 years were 12.1, 12.0, and 11.7mm, respectively. The segmental lordotic angle at postoperative 6 months, 1 year, and 2 years were 14.9, 14.2, and 14.6 degrees, respectively. Fusion rates at postoperative 6-month, 1-year, and 2-year were 85.71%, 96.42%, and 100%, respectively. Complications occurred in 7 of 28 patients, there was no major complication (0%) occurred. Sympathetic chain symptoms were the most common approach-related complications. Conclusion: Oblique lateral interbody fusion could be considered as an acceptable surgical option for degenerative lumbar lesions, especially at L4-5 level.