Vertebrae Coronal Fracture following Oblique lateral Lumbar Interbody Fusion: Case Report

J. Zeng, Long Zhao, Xian-di Wang, T. Xie
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Abstract

Objective: Oblique lateral lumbar interbody fusion (OLIF) surgery has been increasingly proposed a preferred minimally invasive approach for lumbar degenerative pathology. We aimed to report cases with vertebrae coronal fracture (VCF) following OLIF combined with anterolateral single-rod screw fixation (OLIF-AF). Methods: A retrospective review was performed on all patients who underwent minimally invasive OLIF-AF surgery between October, 2017 and February, 2021. Patients with VCF were selected for further analysis. RESULTS: Two patients (0.37%) out of 534 total patients (707 levels) were identified with VCF following OLIF-AF. Both patients presented with severe back pain and radiating to bilateral legs within 10 days after surgery. Both patients were osteoporosis and had improper lumbar motion at early stage postoperative. Managed with conservative treatment, the VCF healed and successful interbody fusion were achieved in both patients. CONCLUSIONS: VCF following OLIF-AF surgery is a rare but anguished complication. The contributing factor may include osteoporosis, overweight and premature improper lumbar motion. Based on these fracture reports, we caution surgeons should repeatedly advise patients to limit lumbar movement at early stage postoperative, especially for osteoporosis patients.
斜侧腰椎椎体间融合术后椎冠状骨折1例报告
目的:斜侧腰椎椎体间融合术(OLIF)越来越多地被认为是治疗腰椎退行性病理的首选微创入路。我们的目的是报道OLIF联合前外侧单棒螺钉固定(OLIF- af)后椎骨冠状骨折(VCF)的病例。方法:回顾性分析2017年10月至2021年2月期间所有接受微创OLIF-AF手术的患者。选择VCF患者进行进一步分析。结果:534例患者(707个级别)中有2例(0.37%)在OLIF-AF后被确定为VCF。术后10天内,两例患者均出现严重的背部疼痛和双侧腿部放射。两例患者均为骨质疏松症,术后早期腰椎运动不正常。在保守治疗下,两例患者VCF均愈合并成功实现椎间融合。结论:OLIF-AF手术后的VCF是一种罕见但痛苦的并发症。诱发因素可能包括骨质疏松症、超重和过早不当的腰椎运动。根据这些骨折报告,我们提醒外科医生应反复建议患者在术后早期限制腰椎活动,特别是骨质疏松症患者。
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