Endo-OLIF (Endoscopically Assisted Oblique Lumbar Interbody Fusion Under O-arm Navigation –Spine Surgery)

What are the indications for the procedure?

The Endo-OLIF surgery is the procedure of choice for treatment and correction of degenerative lumbar scoliosis. Discogenic back pain (single or multiple level) Low grade lumbar spondylolisthesis- bone slip Spinal instability Lumbar spondylosis Degenerative disc disease Failure of previous posterior lumbar fusion surgery with pseudoarthrosis Combined with posterior procedure to enhance bone fusion

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What are other types of Lumbar fusion?

PLIF The Posterior Lumbar Interbody Fusion (PLIF) technique was developed in the 1950s and became the “Golden Standard” to treat disc problems. In the procedure, the spine is approached from a 3-6 inch long incision in the middle of the back, and the lower back muscles are stripped off the lamina on both sides. The lamina bone is then removed (laminectomy) to allow the surgeon to see the nerve roots. The facet joints may then be trimmed back to give the nerves more room, before the nerve roots are moved aside and disc space is cleared out of disc material. A fusion cage containing bone graft material is then inserted into the disc space, allowing bone to grow and connect both vertebrae, completing the fusion. This is a more traditional spine fusion and may be required in some cases, however never techniques are available.  TLIF The Transforaminal Lumbar Interbody Fusion (TLIF) technique became more popular because it allowed for a one-sided approach which improved the access to other disk surfaces to do a posterior fusion. The muscles and nerves were still cut in TLIF which caused significant postoperative issues. To address these issues, a minimally-invasive TLIF was developed to decrease blood loss and lower the complication rate, even though the MIS TLIF took longer to perform than the original TLIF. Patient outcomes were similar for both MIS TLIF and traditional open TLIF, however the MIS TLIF was more technically challenging for the surgeon to perform.  ALIF The Anterior Lumbar Interbody Fusion (ALIF) approach had several key advantages but involved a major abdominal incision. This technique allowed direct view of the disc space and vertebral bodies which permitted easier clearing of the disc space. The back and lateral muscles were spared in the ALIF which reduced postoperative pain.  A consideration was that major organs and blood vessels had to be avoided or moved out of the way. There were significant reasons why some people could not undergo this approach such as prior abdominal surgery or known scar tissue. ALIF also causes retrograde ejaculation in a very small number of male patients (1-2%). However, the complication rates between ALIF and TLIF were similar, including comparable blood collections, wound infections, wound separation, spinal fluid leakage, nerve damage, and non-fusion rates.