• Rusheel Nayak, Jacob Razzouk, Omar Ramos, Shaurya Mehta, Gideon Harianja, Nathaniel Wycliffe, Olumide Danisa, and Wayne Cheng.
• Department of Orthopaedic Surgery, Loma Linda University Health, Loma Linda, CA, USA.
• Eur Spine J. 2024 Jul 1; 33 (7): 260426102604-2610.

PurposeThe primary aim of this study was to describe the feasibility, surgical approach window (SAW), and incision line (IL) for oblique lateral interbody fusion at L5-S1 (OLIF51) using computed tomography (CT). A secondary aim was to identify associations among approach characteristics and demographic and anthropometric factors.MethodsWe performed a radiographic study of 50 male and 50 female subjects who received abdominal CT imaging. SAW was measured as the distance from the midline to the medial border of the iliac vessel. IL was measured at the skin surface corresponding to the distance between the center of the disc space and SAW lateral margin. OLIF51 feasibility was defined as the existence of at least a 1-cm SAW without retraction of soft tissues.ResultsFor the left side, the OLIF51 SAW and IL were 12.1 ± 4.6 and 175.1 ± 55.3 mm. For the right side, these measures were 10.0 ± 4.3 and 185.0 ± 52.5 mm. Correlations of r = 0.648 (p < 0.001) and r = 0.656 (p < 0.001) were observed between weight and IL on the left and right sides, respectively. OLIF51 was not feasible 23% of the time.ConclusionTo our knowledge, this is the largest CT study to determine the feasibility of performing an OLIF51. Without the use of retraction, OLIF51 is not feasible 23% of the time. Left-sided OLIF51 allows for a larger surgical approach window and smaller incision compared to the right side. Larger incisions are required for adequate surgical exposure in patients with higher weight.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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