Perioperative Complications of Oblique Lumbar Interbody Fusion (OLIF): 5 Years of Experience with OLIF.

Objective  The objective of this study was to share our early experience with oblique lumbar interbody fusion (OLIF), with emphasis on the perioperative complications and determine clinical outcomes following OLIF. Materials and Methods  It was a retrospective prospective study performed at a single institute from March 2019 to August 2023. A total of 56 consecutive patients who had undergone OLIF for degenerative spine disorders were enrolled in the study. Pre-, intra-, and postoperative data on these patients were collected. All the patients were followed up at regular intervals with an evaluation of Visual Analog Scale (VAS), Oswestry Disability Index (ODI), neurological parameters, and X-rays to look for fusion, screw loosening, pseudoarthrosis, and cage slippage. Statistical analysis was done with the odds ratio, chi-square test, and Student's t -test. A p- value of < 0.05 was considered significant. Results  The overall incidence of complications was 25%, with no mortality. Intraoperative complications were noted in 10.7% of cases. This included endplate fractures ( n  = 3), peritoneal lacerations ( n  = 2), and ureteric injury ( n  = 1). The most common early postoperative complications were postoperative ileus ( n  = 6), followed by anterior thigh or groin numbness ( n  = 3), ipsilateral psoas weakness ( n  = 2), and superficial surgical site infection ( n  = 2). Of the late postoperative complications, cage subsidence was the most common, which occurred in 4 patients, followed by adjacent segment degeneration ( n  = 2) and loss of indirect decompression ( n  = 1). The mean ODI and VAS scores showed significant improvement ( p  < 0.05) at the final follow-up. Conclusion  OLIF is a promising surgical technique with the potential to treat a variety of degenerative conditions of the lumbar spine with a good clinical outcome. Despite its various benefits, OLIF can lead to complications in rare instances, which every spine surgeon should be aware of.