OLLIF versus OLIF: The Big Difference

Low back pain is a common and expensive condition affecting approximately 80% of the individuals in the Western world at one point in their life. It is costly as it is one of the leading causes of absence and loss of productivity at work for those under the age of 45 years old. It is the third leading cause of surgery and one of the commonest causes for utilization of healthcare services in the United States. The number of disability cases has also risen especially in individuals with intervertebral disc problems.

OLIF & OLLIF – The Similarities

As a treatment for low back pain, oblique lateral lumbar interbody fusion or OLLIF and oblique lumbar interbody fusion (OLIF) are two procedures that are performed to fuse the lumbar vertebrae for patients who experience lower back pain. Both these techniques are minimally invasive and fairly new to the industry. Minimally invasive spinal surgery techniques have many benefits as they require only a small incision to allow the surgeon access to the affected area. There is also less scarring, less blood loss, shorter hospital stays, and faster recovery rates for patients who undergo minimally invasive surgery compared to the traditional open surgery.

Although both techniques have similar names and purpose, the approach these two techniques are different.

OLIF & OLLIF: The Differences

OLLIF is a truly minimally invasive technique requiring no direct visualization while OLIF requires an opening in the anterior abdominal wall. Due to its approach through the abdominal cavity, the major abdominal organs, arteries, and veins need to be mobilized to avoid any injury. It, therefore, necessitates an experienced access surgeon to ensure access to the spine. OLIF is, therefore, more invasive than OLLIF.

This means that the OLIF procedure will possibly need two surgeons: one for the OLIF and another access surgeon. However, the OLLIF surgery is a true one surgeon surgery as all the organs and vessels can be bypassed using the posterior lateral oblique approach.

The positioning of patients in both procedures is also different. In OLIF, patients are positioned in a way to open up space between the ribs and pelvis. This can be a time-consuming process. In OLLIF, patients are placed in the prone position and there is a minimal rotation of the table to achieve the required angle for surgery. The incision for OLLIF is also smaller, with only a 10 – 15 mm size incision required for the entire surgery.

The OLLIF procedure is a straightforward surgery that takes significantly less time, approximately 75 minutes average to complete compared to the OLIF which can take several hours to complete. This is due to the requirements of the OLIF procedure where the sterile field on patients need to be re-positioned and re-prepped.

According to multiple studies, the OLLIF was found to save significant time and shorten hospital stay compared to alternative procedures. It has also been shown to have low risks of infections with excellent outcomes specifically for relief of pain and increased function. Although both procedures can be challenging to perform at the L5/S1 vertebral level, the Inspired Spine OLLIF has revolutionized this technique and it can now be used to overcome this difficulty and fuse vertebrae effectively in the chest area as well (T6 to S1).

References:

• Distinguishing between the spinal OLIF and OLLIF procedures confusion with the war of the LIF’s. Inspired Spine. Accessed 6/23/2017.

• Abbasi H, Abbasi A. Oblique lateral lumbar interbody fusion (OLLIF): technical notes and early results of a single surgeon comparative study. Cureus. 2015; 7(10):e351.