Microscopic Ventral Neural Decompression in Oblique Lateral Interbody Fusion

Objective: To describe the operative methods and to investigate the efficacy of ventral neural decompression under microscopic vision with oblique lumbar interbody fusion (OLIF).

Methods: Twelve patients with extruded or sequestered disk were treated with ventral neural decompression under microscopic vision via the working corridor of routine OLIF. Their clinical data were gathered and analyzed retrospectively. The clinical efficacy was evaluated by the Oswestry Disability Index (ODI), visual analog scale (VAS), and relevant radiographic parameters.

Results: All operations went smoothly, with an average operative time of 151.7 ± 24.5 minutes and blood loss of 58.5 ± 21.3 mL. Well-decompressed canal observed in postoperative magnetic resonance imaging, significant improvements in VAS score for leg (P < 0.01) and ODI score (P < 0.01) confirmed satisfactory ventral neural decompression. Radiographic parameters including disk height (P < 0.01) and segmental disk angle improved significantly (P < 0.01). There was no significant difference between pre- and postoperative lumbar lordosis (P = 0.255). During the follow-up, end plate fracture was observed in 1 case. No major vessels, neural, or dural injury was observed.

Conclusions: Microscopic ventral neural decompression with OLIF could achieve satisfactory clinical results with minimal complications in selected patients with extruded or sequestered disk.