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Great question! In a multiple OLIF (Oblique Lateral Interbody Fusion) scenario, the sequence of levels can depend on various factors, but typically, starting with the most caudal level tends to provide more stable access for the higher levels. This is because the caudal segments provide a more stable foundation, and working from caudal to cranial can allow for sequential release and easier realignment of subsequent levels. This approach can also help reduce the risk of obstructed access to the more caudal levels due to the positioning challenges posed by larger cranial implants. However, specific patient anatomy can significantly influence this decision. The imaging provided shows possible degenerative changes, especially at the L4-L5 level, which would benefit from a more individualized approach. This is where mediCAD® preoperative planning can add real value. mediCAD's 3D planning capabilities would allow you to visualize each segment clearly, determine the exact extent of disc space degeneration, and plan the surgical sequence accordingly to optimize alignment and stability. This precision could be especially beneficial for selecting the order of OLIF levels to ensure the best possible outcome. Looking forward to hearing more insights from others experienced in OLIF. Thanks for sharing this discussion!
Bassel George Diebo, MD Mike Selby Alan H. Daniels, MD and anyone else experienced in OLIF... Which level should be done first in a multiple OLIF scenario? Most cranial? Most caudal? Middle? Why? Thank you for your response.
