Perioperative Complications of Oblique Lateral Interbody Fusion With Unilateral Pedicle Screw Fixation in a Single Lateral Position: A Retrospective Case Series
Yonghui Zhao, Weicheng Lin, Qiunan Lyu, Qiyang Wang, Jiayu Chen, Weichao Li, Hui Zhong, Jie Liu, Sheng LuStudy Design
Retrospective case series.
Objectives
To analyze the perioperative complications of oblique lateral interbody fusion (OLIF) combined with unilateral pedicle screw fixation performed in a single lateral position.
Methods
Clinical data of 258 consecutive patients with lumbar degenerative diseases undergoing OLIF-UPS fixation in a single lateral position from July 2019 to June 2025 were collected. Both single- and multi-segment fusions were included. Demographic, intraoperative and perioperative data were extracted for statistical analysis.
Results
Among the 258 patients, the overall perioperative complication rate was 17.1%. Neurological deficits (6.2%) and pedicle screw insertion-related complications (5.4%) were the most common. Other complications included endplate injury (3.5%), cage malposition (2.7%), poor incision healing (1.9%), anterior longitudinal ligament injury (1.6%), vascular injury (1.6%), cage subsidence (1.2%), intestinal obstruction (1.2%), and peritoneal injury (0.4%). The complication rate was higher in the Multi-level fusion group than in the single-level group (21.9% vs. 15.5%, P=0.237). The incidences of neurological deficits (7.8% vs. 5.7%, P=0.538) and screw-related complications (7.8% vs. 4.6%, P=0.331) were also higher in the Multi-level group; however, none of these differences reached statistical significance.
Conclusions
The overall perioperative complication rate in this cohort was 17.1%, and the perioperative complications were manageable. Further controlled studies with long-term follow-up are needed to compare its efficiency and safety with alternative fixation protocols and positioning strategies.