Oblique lateral interbody fusion (OLIF) compared with unilateral biportal endoscopic lumbar interbody fusion (ULIF) for degenerative lumbar spondylolisthesis: a 2-year follow-up study

Journal of Orthopaedic Surgery and Research · 5 authors, 3 centres

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TL;DR

This comparative cohort study evaluated OLIF combined with anterolateral fixation (OLIF-AF) versus unilateral biportal endoscopic lumbar interbody fusion (ULIF) in 107 patients with degenerative lumbar spondylolisthesis. The central result was that OLIF-AF showed superior restoration of lumbar sagittal parameters and earlier intervertebral fusion rates at 3 and 6 months postoperatively.

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The study included 107 patients with degenerative lumbar spondylolisthesis, divided into an OLIF-AF group (n=45) and a ULIF group (n=62). Key findings indicated that the OLIF-AF group had significantly reduced blood loss and operation time, superior low back pain VAS scores throughout follow-up, and greater improvements in disk height, lumbar lordosis, and segmental lordosis. The fusion rate was significantly higher in the OLIF-AF group at 3 and 6 months postoperatively, but not at the final follow-up. Complication rates were comparable. The implications suggest OLIF-AF may offer advantages for sagittal parameter restoration and early fusion, but long-term outcomes were similar.

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cohort

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surgery

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ORIGINAL PAPER

PMC10463437

Oblique lateral interbody fusion (OLIF) compared with unilateral biportal endoscopic lumbar interbody fusion (ULIF) for degenerative lumbar spondylolisthesis: a 2-year follow-up study

Journal of Orthopaedic Surgery and Research

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ABSTRACT

Abstract Background Oblique lumbar interbody fusion (OLIF) has been proven to be an effective method of indirect decompression for the treatment of Degenerative Lumbar Spondylolisthesis (DLS). However, its superiority over Unilateral biportal endoscopic Lumbar Interbody Fusion (ULIF) has not been reported yet. The current study aimed to compare the clinical and radiological outcomes of OLIF and ULIF in patients with DLS. Methods A total of 107 patients were included in this study, divided into two groups according to the surgical methods with 45 patients treated by OLIF combined with anterolateral single screwrod fixation, and 62 patients treated by ULIF. To compare the perioperative parameters (blood loss, operation time, and postop hospitalization) and clinical (the Visual Analog Scale (VAS) scores of the low back pain and leg pain and the Oswestry Disability Index (ODI)) and radiological (disk height (DH), lumbar lordosis (LL), segmental lordosis (SL), the cross-sectional area (CSA) of the spinal canal) results of the two surgical approaches to evaluate their efficacy. Results Compared with the ULIF group, the blood loss and operation time in the OLIF-AF group were significantly reduced, and the Postop hospitalization was comparable. The VAS scores in both groups were significantly improved compared to preop; however, the VAS score of low back pain in the OLIF-AF group was superior to that in ULIF group throughout the follow-up period ( P < 0.05). The improvements in DH, LL, and Segmental angle were significantly lower in the ULIF group, and the expansion rate of CSA in the OLIF-AF group was superior to that in the ULIF group, but the difference was not statistically significant. The fusion rate in OLIF-AF group was significantly higher than that in ULIF group within 6 mo postop, and there was no significant difference at the last follow-up. The incidence of complications was comparable between the two groups, and there was no statistical difference. Conclusions Both OLIF-AF and ULIF achieved good short-term results in the treatment of DLS, and both surgical approaches are desirable. However, OLIF-AF has advantages over ULIF in terms of postoperative restoration of lumbar sagittal parameters and earlier intervertebral fusion. Long-term follow-up and larger clinical studies are needed to confirm this result. Keywords: OLIF-AF, ULIF; DLS, Clinical efficacy, Radiological results

CITATION EXPORT

Shuyan Cao, Bingjie Fan, Xin Song et al.. Oblique lateral interbody fusion (OLIF) compared with unilateral biportal endoscopic lumbar interbody fusion (ULIF) for degenerative lumbar spondylolisthesis: a 2-year follow-up study. Journal of Orthopaedic Surgery and Research. (2023). https://doi.org/10.1186/s13018-023-04111-x

AUTHORS

5 · 3 CENTRES

Shuyan Cao, Bingjie Fan, Xin Song, Yi Wang, Wenzhe Yin

1Department of Orthopaedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China
2Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou China
3Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan China