Comparison Of Oblique Lateral And Posterior Lumbar Interbody Fusion For Treatment Of Lumbar Degenerative Disease

ObjectiveTo compare the clinical outcomes,radiographic parameters and perioperative complications of oblique lateral interbody fusion(OLIF)and posterior lumbar interbody fusion(PLIF)for the treatment of degenerative lumbar disease.MethodsFrom January 2018 to December 2019,a total of 87 patients with degenerative lumbar disease were retrospectively analyzed.According to the surgical method,87 patients were divided as OLIF group(n=41)and PLIF group(n=46).In the OLIF group,20 patients underwent Stand-Alone OLIF and 21 patients underwent OLIF combined with bilateral pedicle screw fixation.The operative time,intraoperative blood loss,transfusion rate,time to walking and length of hospital stay were recorded in both groups.Besides,clinical outcomes were evaluated by visual analogue scale(VAS)and Oswestry disability index(ODI)score.Radiographic parameters were assessed by disc height(DH),lumbar lordosis(LL),fused segmental lordosis(FSL)and fusion rate.ResultOLIF significantly reduced operative time,intraoperative blood loss,transfusion rate,time to walking and length of hospital stay compared to PLIF(P<0.05).Moreover,OLIF was superior to PLIF in the improvement of early postoperative VAS-back score and ODI.However,there were no significant differences in the VAS-leg score,final follow-up VAS-back score and ODI between the two groups(P>0.05).The amount of change between preoperative and postoperative DH in OLIF group were significantly higher than that in PLIF group.However,there were no significant differences in fusion rate and incidence of complications between the two groups(P>0.05).Besides,there were no significant differences in the correction of LL and FSL between the Stand-Alone OLIF group and PLIF group(P>0.05).However,OLIF combined with posterior internal fixation was superior to PLIF in the correction of LL and FSL(P<0.05).ConclusionThis study indicated that the final follow-up clinical outcomes,complication rate of OLIF were similar to those of PLIF for the treatment of degenerative lumbar disease.However,OLIF showed advantages in less surgical trauma,faster recovery,early postoperative relief of back pain and the improvement of DH.In addition,OLIF combined with posterior internal fixation can better correct lumbar lordosis.