Abstract

This study aimed to perform a comparative analysis of postoperative results between lumbar degenerative spondylolisthesis (LDS) treated with oblique lateral interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF) from the Chiba spine surgery registry database. Sixty-five patients who underwent single-level OLIF (O group) for LDS with ≥ 3 years’ follow-up were retrospectively reviewed. The control group comprised 78 patients who underwent single-level TLIF (T group). The analyzed variables included global alignment, radiological parameters of fused segments, asymptomatic and symptomatic ASD incidence, clinical outcomes at 3 years postoperatively using the Japanese Orthopedic Association Back Pain Evaluation Questionnaire data, visual analogue scale scores for low back pain, lower extremity pain, and lower extremity numbness. There was no significant change in global alignment between the two groups. The rate of improvement in anterior intervertebral disc height was not significantly different between the groups at 1-month postoperatively. However, at the final evaluation, the anterior intervertebral disc height and incidence of asymptomatic ASD were significantly higher in the O group. There was no significant difference in symptomatic ASD, reoperation cases, or clinical results between groups. Thus, single-level OLIF can maintain the corrected disc height, but as it has no effect on global alignment, its benefit is limited.

Highlights

  • This study aimed to perform a comparative analysis of postoperative results between lumbar degenerative spondylolisthesis (LDS) treated with oblique lateral interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF) from the Chiba spine surgery registry database

  • Among 14,267 patients enrolled in the Chiba spine surgery registry (CSSR) database since 2012, patients with lumbar spinal canal stenosis associated with LDS and neurological symptoms in the lower extremities who received single-level OLIF and single-level TLIF were included in this study

  • The results of the present study suggest that the progression to symptomatic adjacent segment disorder (ASD) may follow a similar process for OLIF and TLIF

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Summary

Introduction

This study aimed to perform a comparative analysis of postoperative results between lumbar degenerative spondylolisthesis (LDS) treated with oblique lateral interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF) from the Chiba spine surgery registry database. OLIF has been used in the treatment of LDS and its indirect decompression effect results in progressive widening of the dural canal, resulting in improvement of neurological symptoms in the lower e­ xtremities[4,5] This technique involves the insertion of a cage with a height larger than the preoperative disc height to achieve indirect decompression, which may have an impact on the adjacent vertebrae. The purpose of this study was to extract cases from the Chiba spine surgery registry (CSSR) database in which single-level OLIF and conventional single-level TLIF were performed for LDS and perform a comparative analysis of changes in global alignment, incidence of ASD, and clinical outcome 3 years after surgery

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