Pedicle Lengthening Osteotomy for Lumbar Spinal Stenosis: A Systematic Review of Cadaveric, Computational, and Clinical Outcomes.

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Abstract

Conflict of interest statement: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. 20. World Neurosurg. 2025 Nov;203:124490. doi: 10.1016/j.wneu.2025.124490. Epub 2025 Sep 22. Ibero-Latin American Consensus on Oblique Lumbar Interbody Fusion (L2-L5): A Modified Delphi Study. Landriel F(1), Campos de Barros AG(2), Ciancio RAM(3), Vega A(4), Teles AR(5), Silva González Á(6), Arellanes-Chávez CA(7), Suárez-Fernández D(8), Bordon G(9), Gutierrez J(10), Malheiros JA(11), Fernández Sánchez JC(12), Alba NM(13), Taboada N(14), Vela P(15), Bermudez R(16), Rivera Colón YC(17), Baranov B(18), Hem S(19). Author information: (1)Neurosurgical Department, Spine Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: federico.landriel@hospitalitaliano.org.ar. (2)INTO, Rio de Janeiro, Brazil. (3)Orthopedics Department, Spine Unit, Hospital Pediátrico Humberto Notti, Mendoza, Argentina. (4)Department of Neurosurgery, Spine Unit, Hospital Ángeles del Pedregal, Cuidad de México, México. (5)Department of Neurosurgery, Hospital São José-Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil. (6)Orthopedics Department, Clínica Alemana, Santiago, Chile. (7)Neurosurgical Department, Star Médica, Hospital Central Universitario de Chihuahua, Chihuahua, México. (8)Neurosurgical Department, Complejo Hospital Universitario de la Coruña, La Coruña, Spain. (9)Orthopedics Department, Spine Unit, Hospital de Manises, Manises, Spain. (10)CR Spine Institute, Hospital Cima, San José, Costa Rica. (11)Spine Unit, Hospital Orizonti, Belo Horizonte, Mina Gerais, Brazil. (12)Orthopedics Department, Spine Unit, Hospital Calderón Guardia, San José, Costa Rica. (13)Neurosurgical Department, Hospital Federico Lleras Acosta, Ibague, Colombia. (14)Neurosurgical Department, Spine Unit, Clínica Portoazul, Barranquilla, Colombia. (15)Department of Neurosurgery, Spine Unit, Clínica los Rosales, Pereira, Colombia. (16)Neurosurgical Department, Ciudad de la Salud-Caja de Seguros Social, Panama City, Panama. (17)Puerto Rico Spine Center, Doctors Center Hospital, San Juan, Puerto Rico. (18)Medtronic Latam Medical Science, Santiago, Chile. (19)Neurosurgical Department, Spine Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. OBJECTIVE: To establish expert consensus on the surgical application of oblique lumbar interbody fusion at the L2/5 spinal level (OLIF 25) using a modified Delphi process. METHODS: Seventeen experienced spine surgeons from Iberia and Latin America participated in a four-round Delphi process (one face-to-face and three online surveys) conducted between July 2024 and April 2025. Consensus was defined as ≥70% agreement and graded as strong (≥90%), moderate (80%-89.9%), or weak (70%-79.9%). RESULTS: A total of 56 statements across four domains (preoperative assessment, technology/instrumentation, intraoperative considerations, postoperative care) were evaluated. Consensus was achieved for 45 statements (80.4%), including 11 with strong agreement, 17 moderate, and 6 weak. Additional items were classified as optional recommendations (12.5%) or findings (7.1%). Key agreements included mandatory magnetic resonance imaging for corridor assessment, indirect foraminal decompression, and grade I degenerative spondylolisthesis as favorable indications. Major contraindications were severe canal stenosis with blocked facets and prior ipsilateral retroperitoneal surgery. High-risk steps identified were pin fixation, tubular retractor opening, and anterior longitudinal ligament release. CONCLUSIONS: This study provides the first Delphi-based regional consensus specifically addressing OLIF 25. It delivers structured expert guidance on imaging, indications, contraindications, and intraoperative safety maneuvers, offering a framework to standardize OLIF 25 practice in Ibero-Latin America. Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.wneu.2025.124490