Prevention of Vascular Injuries during Oblique Lumbar Interbody Fusion: Tips for Management of Vascular Injury

Abstract

Introduction: Introduction of procedures such as oblique lateral interbody fusion (OLIF25) and OLIF51 have led to significant advances in the domain of spine surgery. OLIF25 enables access to the L1-L5 intervertebral discs without splitting the psoas muscle, and OLIF51 provides access to the L5-S1 intervertebral discs. Despite being less invasive, reportedly, these approaches were associated with vascular injury in 3.6% of patients, and preventive measures are warranted.

Technical Note: Preoperative three-dimensional reconstructed computed tomographic images provide accurate visualization of the surgical approach, which may reduce the risk of vascular injury. However, in the event of such injury, prompt and accurate intervention is important to avoid fatality. In addition to a discussion regarding the role of preoperative imaging in vascular injury prevention, we discuss strategies for management of vascular injuries (both arterial and venous).

Conclusions: Preoperative imaging, as well as improved knowledge and skills for management of inadvertent intraoperative vascular injuries during OLIF are important for patient safety.