Introducing
Your new presentation assistant.
Refine, enhance, and tailor your content, source relevant images, and edit visuals quicker than ever before.
Trending searches
Honorary Clinical Assoicate Professor
The Chinese University of Hong Kong
6min25S
If patient need direct or indirect decompression
Age >60 yo
Female
Osteoporosis
Spondylolisthesis/Scoliosis
If only one or less factor can have standalone +/- vertebral body screw and plate
If two or more factor consider Pedicle screw / corticle screw +/- cement augmentation
Cardiopulmonary function
blooding tendancy
Abdominal surgery
Risk of infection
OLIF position
no need to break table
True lateral and AP X-ray
DLIF position
17:13-19:08
see and dissect before insertion of retractor
Case demonstration
Complication avoidance
Video demonstration
OLIF25 surgical video
Type of lateral instrumentation
OLIF 64
OLIF+DLIF 2
OLIF+AXIALIF 1
DLIF 29
Veo 2
XLIF 2
Type of additional posterior fixation
Pedicle screws (bilateral) 51
cement augmented pedicle screws 16
Cortical screw (MLIF) 6
Unilateral pedicle screw 4
Standalone cage(s) 23
Staged surgery
complete in one stage 91
complete in two stages 9
level of lateral lumbar fusion involved
one level 71
two level 28
three level 1
No major complications e.g. intra-abdominal hemorrhage, cage infection, permanent nerve damage.
1 residual nerve compression after indirect decompression need secondary decompression surgery
2 cases cage subsidence without need for surgery (one standalone and one unilateral screw)
Successful decompression with residual lower limb symptoms:
one thoracic myelopathy.
One with concomitant cervical myelopathy.
one with subsequent diagnosis multiple sclerosis.
5 cases of delay adjacent level disease:
2 need decompression surgery
3 need medication or radiofrequency treatment
Overall 95% satisfied with the long term outcome.
Need careful analysis of preoperative images, especially the anatomy of the facet joint and foramen. This is to assess the need for direct decompression.
Always use wider and longest cage to reduce chance of cage subsidence.
Always use bilateral pedicle or cortical screw if there is risk factor for cage subsidence:
age over 60; scoliosis or spondylolisthesis; Female; Osteoporosis.
If in doubt applied pedicle screw fixation
Best position for cage insertion is lateral decubitus
Best position for pedicle or cortical screw fixation is prone position with back at physiological lordosis.
screening of whole spine before complex lumbar spine surgery.
Shifting from DLIF to OLIF except at specific condition.