• Yachong Huo, Wenyuan Ding, Samuel Rudd, Dalong Yang, Lei Ma, Ruoyu Zhao, and Sidong Yang.
• Department of Spine Surgery, The Third Hospital of Hebei Medical University, 139Ziqiang Rd, Shijiazhuang, 050051, China.
• Eur Spine J. 2023 Jan 1; 32 (1): 336344336-344.

PurposeTo investigate the incidence and risk factors of lumbar plexus injury (LPI) after oblique lumbar interbody fusion (OLIF) surgery.MethodsA total of 110 patients who underwent OLIF surgery between January 2017 and January 2021 were retrospectively reviewed. Patients were divided into two groups: the group with LPI (LPI group) and the group without LPI (non-LPI group). The baseline demographic data, surgical variables and radiographic parameters were compared and analyzed between these two groups.ResultsAmong all participants, 13 (8.5%) had LPI-related symptoms postoperatively (short-term), and 6 (5.5%) did not fully recover after one year (long-term). Statistically, there were no significant differences in the baseline demographic data, surgery duration, intraoperative blood loss, preoperative diagnosis, surgical procedures used and incision length. Compared with the non-LPI group, patients in the LPI group had a narrower OLIF channel space. In LPI group, the anterior edge of left psoas major muscle overpasses the anterior edge of surgical intervertebral disk (IVD) on axial MRI. Logistic regression analysis revealed that narrow OLIF channel space and the anterior edge of left psoas major muscle overpassing the anterior edge of surgical IVD on axial MRI were independently associated with both short-term and long-term LPI.ConclusionNarrow OLIF channel space and the anterior edge of left psoas major muscle overpassing the anterior edge of surgical IVD are significant risk factors of OLIF surgery-related LPI. Surgeons should use preoperative imaging to adequately assess these risk factors to reduce the occurrence of LPI.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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