Comparative analysis of tubular retractors and hook retractors in oblique lumbar interbody fusion at the initial stage of the learning curve.

Abstract

Oblique lumbar interbody fusion (OLIF) still has a steep learning curve that many spinal surgeons who want to develop are hesitant. The purpose of this study is to provide reference for beginners through the comparative analysis of the application of two kinds of retraction devices in the early stage of learning curve. We prospectively included the first 60 patients with lumbar degenerative diseases treated with OLIF by a surgeon in our department. According to the application of different retraction devices during the operation, the patients were divided into hook retractor group and tubular retractor group. The clinical effects and complications of the two groups were compared. The average age of hook retractor group was 62 years old, the average age of tubular retractor group was 65 years old. There was no significant difference in age, sex, operative segment, follow-up time and blood loss between the two groups. The operation time in hook retractor group was less than that in tubular retractor group. The incidence of complications in hook retractor group (11.8%) was significantly lower than that in tubular retractor group (38.5%). The tubular retractor group has a higher risk of neurovascular injury in the initial stage of learning, as well as the risk of vertebral fracture. In contrast, the hook retractor group has the advantages of simple method, high fault tolerance and relatively low incidence of complications. Therefore, we believe that the application of hook retractor in the early stage of OLIF learning curve is easier to increase the operator's confidence and make OLIF more acceptable.