We are all familial with TLIF and PLIF for spinal fusion and the indications are well known and we are addressing the pathology directly . But in OLIF and DLIF we are approaching the he disease in directly which I can't understand why. I have seen patient who present with severe retroperitoneal infection post OLIF which the surgeon who did the surgery refused to treat the complication
To my mind, these techniques primarily serve to achieve minimal access inter-body fusion in deformity correction in the absence of significant neural compression. The limitations attached to the lordotic angles of the cages have been recently addressed with more lordotic implants. with this in mind, I have been able to achieve excellent inter-body corrections with the new expandable TLIF cages, that have up to 15 degrees lordosis which means that i can do it all form the back!.
I am struggling with the concept of the indirect decompression achieved with these techniques but this view is not uniformly shared within the department and we are in the process of reviewing our indirect decompression cases to evaluate the PROMS.
I agree with the concerns of Dr. Khalid Salem. I really think the answer could be that the indications as far as the nosology is concerned do not differ. It is rather a matter of less invasive or more invasive approach. Unfortunately, LIS or MIS are not always applicable, and the application of similar techniques may lead to compromising results if they are used in the wrong patient.
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