{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T09:18:11Z","timestamp":1787735891648,"version":"build-2784847793"},"reference-count":16,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Indirect decompression through restoration of disc and foraminal height with a large lateral interbody cage has been advocated for selected patients, but its efficacy in a large series remains unproven. In this retrospective study, we evaluated the clinical and radiographic results of indirect decompression achieved by posterior longitudinal ligament (PLL) ligamentotaxis in minimally invasive oblique lateral interbody fusion (MIS-OLIF) performed without posterior decompression. Methods: We retrospectively reviewed 236 consecutive patients treated for single- or two-level degenerative lumbar disease (November 2019\u2013May 2025); clinical follow-up of at least 24 months was available in 181 patients. Visual analogue scale (VAS) scores and radiographic parameters\u2014disc height, foraminal height, foraminal area, spinal canal diameter and cross-sectional area (CSA) of the thecal sac\u2014were compared before and after surgery, and extension ratios were correlated with preoperative values. Results: Clinical scores improved significantly. All radiographic parameters increased substantially: disc height +49.1%, foraminal height +33.7%, foraminal area +44.5%, canal diameter +37.4% and CSA +36.2%. Extension ratios were inversely correlated with preoperative values. Six patients (2.5%) required additional posterior decompression. The slippage subgroup showed greater radiographic gains than the stenosis subgroup. Conclusions: MIS-OLIF without posterior decompression significantly enlarged the foramen and spinal canal; reduction in disc bulging and PLL ligamentotaxis may contribute to this effect, with greater improvement in more severely degenerated, overtly slipped segments. Careful patient selection remains essential, and prospective comparative studies with longer follow-up are needed.<\/jats:p>","DOI":"10.3390\/jcm15176572","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T08:11:15Z","timestamp":1787731875000},"page":"6572","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Indirect Decompression by Posterior Longitudinal Ligament Ligamentotaxis in Minimally Invasive Oblique Lateral Interbody Fusion (MIS-OLIF) Without Posterior Decompression for Degenerative Lumbar Disease"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2184-0044","authenticated-orcid":false,"given":"Jung-Woo","family":"Hur","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Eunpyeong St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4422-2997","authenticated-orcid":false,"given":"Dong Hun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Bucheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Bucheon 14647, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seonyong","family":"Yun","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Eunpyeong St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6453-0439","authenticated-orcid":false,"given":"Jae Taek","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Eunpyeong St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.jocn.2017.06.061","article-title":"Indirect decompression in spinal surgery","volume":"44","author":"Yoshihara","year":"2017","journal-title":"J. Clin. Neurosci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S331","DOI":"10.1097\/BRS.0b013e3182022db0","article-title":"A radiographic assessment of the ability of the extreme lateral interbody fusion procedure to indirectly decompress the neural elements","volume":"35","author":"Oliveira","year":"2010","journal-title":"Spine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"E175","DOI":"10.1097\/BRS.0000000000000703","article-title":"Effect of indirect neural decompression through oblique lateral interbody fusion for degenerative lumbar disease","volume":"40","author":"Fujibayashi","year":"2015","journal-title":"Spine"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"89","DOI":"10.4184\/asj.2012.6.2.89","article-title":"Complications and morbidities of mini-open anterior retroperitoneal lumbar interbody fusion: Oblique lumbar interbody fusion in 179 patients","volume":"6","author":"Silvestre","year":"2012","journal-title":"Asian Spine J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1007\/s00586-016-4465-9","article-title":"Minimally invasive anterior oblique lumbar interbody fusion (OLIF)","volume":"25","author":"Mehren","year":"2016","journal-title":"Eur. Spine J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.3349\/ymj.2015.56.4.1051","article-title":"Mini-open anterior retroperitoneal lumbar interbody fusion: Oblique lateral interbody fusion for lumbar spinal degeneration disease","volume":"56","author":"Ohtori","year":"2015","journal-title":"Yonsei Med. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/S0268-0033(96)00067-8","article-title":"Precision measurement of disc height, vertebral height and sagittal plane displacement from lateral radiographic views of the lumbar spine","volume":"12","author":"Frobin","year":"1997","journal-title":"Clin. Biomech."},{"key":"ref_8","first-page":"35","article-title":"Foraminal height measurement techniques","volume":"1","author":"Phan","year":"2015","journal-title":"J. Spine Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.3349\/ymj.2013.54.6.1498","article-title":"Changes in spinal canal diameter and vertebral body height with age","volume":"54","author":"Kim","year":"2013","journal-title":"Yonsei Med. J."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Iwahashi, H., Yoshimura, N., Hashizume, H., Yamada, H., Oka, H., Matsudaira, K., Shinto, K., Ishimoto, Y., Nagata, K., and Teraguchi, M. (2016). The association between the cross-sectional area of the dural sac and low back pain in a large population: The Wakayama Spine Study. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0160002"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1007\/s00586-015-4170-0","article-title":"Radiographic evaluation of indirect decompression of mini-open anterior retroperitoneal lumbar interbody fusion: Oblique lateral interbody fusion for degenerated lumbar spondylolisthesis","volume":"26","author":"Sato","year":"2017","journal-title":"Eur. Spine J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"329","DOI":"10.3171\/2012.1.SPINE11528","article-title":"Indirect foraminal decompression after lateral transpsoas interbody fusion","volume":"16","author":"Kepler","year":"2012","journal-title":"J. Neurosurg. Spine"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/j.wneu.2017.07.045","article-title":"Bony lateral recess stenosis and other radiographic predictors of failed indirect decompression via extreme lateral interbody fusion: Multi-institutional analysis of 101 consecutive spinal levels","volume":"106","author":"Wang","year":"2017","journal-title":"World Neurosurg."},{"key":"ref_14","first-page":"100279","article-title":"Factors affecting successful immediate indirect decompression in oblique lateral interbody fusion in lumbar spinal stenosis patients","volume":"16","author":"Park","year":"2023","journal-title":"N. Am. Spine Soc. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"110","DOI":"10.3171\/2013.4.SPINE12319","article-title":"Radiographic and clinical evaluation of cage subsidence after stand-alone lateral interbody fusion","volume":"19","author":"Marchi","year":"2013","journal-title":"J. Neurosurg. Spine"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.spinee.2010.09.026","article-title":"Incidence and prevalence of surgery at segments adjacent to a previous posterior lumbar arthrodesis","volume":"11","author":"Sears","year":"2011","journal-title":"Spine J."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6572\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T08:26:43Z","timestamp":1787732803000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6572"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,26]]},"references-count":16,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15176572"],"URL":"https:\/\/doi.org\/10.3390\/jcm15176572","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,26]]}}}