Analysis Of Spinal And Pelvic Parameters And Clinical Effect Of Oblique Lateral Interbody Fusion In The Treatment Of Degenerative Lumbar Spondylolisthesis

Objective:This study was aimed to analysis the spinal and pelvic parameters and clinical effect of obliquely lateral interbody fusion(OLIF)in the treatment of degenerative lumbar spondylolisthesis.Methods:In total,20 patients with L4-5 mild degenerative lumbar spondylolisthesis were treated with OLIF combined with posterior percutaneous pedicle screw fixation for degenerative spondylolisthesis in our department from January 2018 to October 2019.There were 8males and 12 females.clinical outcomes included : intraoperative blood loss,operative time,visual analog scale(VAS),Oswestry disability index(ODI),complications,length of hospital stay and fusion rate and radiographic outcomes measures included : slip precentage(SP),disc height(DH),foraminal height(FH),angle of slip(AS),lumbar lordosis(LL),sacral slope(SS),pelvic tilt(PT),pelvic incidence(PI)and the L1 axis S1 distance(LASD).According to changes of VAS?3or not,patients were divided into two groups.In group A patients were more than or equal to 3 and in group B were less than 3,and then their postoperative spinal and pelvic parameters were compared.Results:All operations were successfully completed and the minimum follow-up time was more than 6 months.The average operation time was 109.50±0.91 min,the average intraoperative blood loss was 72.97±0.87 ml.The average hospital stay was3.72±0.11 d.One patient had symptoms of nerve injury such as hip flexion weakness on the first day after operation.After conservative treatment,the symptoms were relieved.At last follow-up,the muscle strength was completely recovered.The VAS score and ODI index decreased from 6.35 ± 0.13 and 82.88 ± 1.21 before operation to2.25 ± 0.31 and 12.19 ± 0.38 at the last follow-up which all have significant differences.Except for PI,the parameters related to spondylolisthesis and spine pelvis were significantly improved compared with those before operation.There were 15 patients in group A and 5 patients in group B.compared with group A,PT and LASD in group B were higher,while PI and SS were lower in group B,both of them have significant differences.but there was no significant difference between the two groups in post operative |PI-LL|.Conclusions:1.OLIF combined with posterior percutaneous pedicle screw fixation is effective in the treatment of mild degenerative lumbar spondylolisthesis.2.OLIF combined with posterior percutaneous pedicle screw fixation can effectively reconstruct the sagittal spinopelvic parameters of spine and pelvis in patients with mild degenerative lumbar spondylolisthesis.3.In patients the changes of VAS?3,has smaller Pt and LASD than the changes of VAS<3.But the SS and PI were larger in the changes of VAS?3 group.Spinal surgeons should pay attention to the changes of these parameters during the operation.