Preliminary Application of Oblique Lateral Interbody Fusion Combined with Endoscopy in the Treatment of Lumbar Disc Herniation with Lumbar Spinal Stenosis under Computer-assisted Navigation in a Single Position
Objective To introduce the surgical technique and initial clinical results of oblique lateral interbody fusion(OLIF)combined with endoscopic decompression under computer-assisted navigation for the treatment of L5/S1 disc herniation with stenosis.Methods A retrospective study was conducted on 25 patients with L5/S1 disc herniation and stenosis who underwent surgical treatment,including 9 males and 16 females;The age range was 50-79 years old,with an average of 65.5 years old.The navigation assisted single position endoscopic direct decompression combined with OLIF indirect decompression treatment was used.The patient's responsible vertebral body height,intervertebral foramen height,sagittal diameter of lumbar vertebral canal,visual analog scale(VAS),Oswestry disability index(ODI),surgical blood loss,surgical time,ambulation time,hospitalization time,and postoperative cage subsidence were observed and recorded.Results All patients were followed up for more than one year,and no serious complications occurred during the operation.The average operation time was 190 min,intraoperative blood loss was 104 mL,ambulation time was 54 h,and hospitalization time was 10.6 d.During the 1-year follow-up,the postoperative VAS for pain,ODI score,height between the responsible vertebral bodies,intervertebral foramen height,and sagittal diameter of the vertebral foramen were significantly improved as compared with those before surgery.Lumbar CT at 1-year follow-up showed a fusion rate of 92%(23/25)at grade 2 or above(complete fusion,solid fusion).No intervertebral cage subsidence occurred.Conclusion The combination of endoscopic decompression and OLIF surgery under computer-assisted navigation in a single position combines the advantages of direct decompression by endoscopy and the minimally invasive fusion by OLIF.This surgical method is effective in the treatment of L5/S1 disc herniation combined with spinal stenosis,and the initial clinical results are satisfactory.
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