Our Summary

This research paper is about a specific type of surgery called Oblique Lateral Interbody Fusion (OLIF), which is commonly used to treat a condition where the discs in the lower back (lumbar) area degenerate or wear out. The researchers wanted to know how stable this surgery is, particularly when it is combined with two other procedures: the addition of a screw and rod to the back of the spine (Posterior Pedicle Screw and Rod or PSR), and the addition of a screw and rod to the outer layer of the spine (Cortical Screw and Rod or CSR).

To do this, they created a detailed computer model (finite element model) of the lower part of the spine. They then used this model to simulate the surgery and measure the impact on movement (Range of Motion or ROM), stress on the end plate (a part of the vertebra), and stress on the added screws and rods.

The results showed that the OLIF surgery alone reduced movement but did not provide enough stability. However, when combined with either the PSR or CSR procedures, stability was significantly improved. The stress on the end plate was highest for the standalone surgery, while the CSR procedure had the highest internal fixation stress, which was mostly located at the end of the screw.

In simpler terms, the study suggests that while the OLIF surgery is helpful in reducing movement, to ensure sufficient stability, it might be beneficial to combine it with other procedures that involve adding screws and rods to the spine.

FAQs

  1. What is Oblique Lateral Interbody Fusion (OLIF) and what is it used for?
  2. How does the addition of posterior pedicle screw and rod (PSR) or cortical screw and rod (CSR) improve the biomechanical stability of the OLIF surgery?
  3. What is the difference in range of motion and stress levels between the different models of OLIF surgery in the study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lumbar fusion is to consider adding posterior pedicle screw and rod or cortical screw and rod instrumentation to the surgery. This can significantly improve the biomechanical stability of the segment undergoing surgery and reduce stress on the vertebral endplates. It is important to discuss all options with your surgeon to determine the best approach for your specific condition.

Suitable For

Patients who are typically recommended for lumbar fusion surgery include those with severe degenerative disc disease, instability of the spine, spondylolisthesis, spinal stenosis, and other spinal conditions that have not responded to non-surgical treatments. These patients may be experiencing debilitating pain, weakness, numbness, or loss of function in the lower back and legs. Lumbar fusion surgery may be recommended as a last resort when conservative treatments have failed to provide relief.

Timeline

Before lumbar fusion:

  1. Patient experiences chronic lower back pain, sciatica, or other symptoms related to lumbar degenerative disc disease.
  2. Patient undergoes imaging studies such as X-rays, MRI, or CT scans to confirm the diagnosis.
  3. Patient may undergo conservative treatments such as physical therapy, medications, or injections to manage symptoms.
  4. If conservative treatments are ineffective, patient may be recommended for lumbar fusion surgery.

After lumbar fusion:

  1. Patient undergoes pre-operative assessment and preparation for surgery.
  2. Patient undergoes lumbar fusion surgery, which may involve oblique lateral interbody fusion (OLIF) with or without posterior pedicle screw and rod (PSR) or cortical screw and rod (CSR) instrumentation.
  3. Patient experiences post-operative pain and discomfort, and may require pain medications and physical therapy for recovery.
  4. Patient gradually resumes normal activities and experiences improved symptoms over time.
  5. Patient undergoes follow-up appointments with the surgeon to monitor healing and outcomes of the fusion surgery.

What to Ask Your Doctor

  1. What is the success rate of lumbar fusion surgery for my specific condition?
  2. What are the potential risks and complications associated with lumbar fusion surgery?
  3. How long is the recovery period after lumbar fusion surgery?
  4. Will I need physical therapy or rehabilitation after the surgery?
  5. How will my daily activities be affected after lumbar fusion surgery?
  6. Are there any alternative treatments to lumbar fusion that I should consider?
  7. How long do the internal fixation devices typically remain in place after lumbar fusion surgery?
  8. What type of follow-up care will be required after lumbar fusion surgery?
  9. What are the chances of needing additional surgery in the future after lumbar fusion?
  10. Can you provide me with information about your experience and success rate with lumbar fusion procedures?

Reference

Authors: Huang S, Min S, Wang S, Jin A. Journal: BMC Musculoskelet Disord. 2022 Jun 27;23(1):611. doi: 10.1186/s12891-022-05553-w. PMID: 35761228