Abstract

Minimal invasive spinal fusion has become popular in the last decade. Oblique lumbar interbody fusion (OLIF) is a relatively new surgical technique and could avoid back muscle stripping and posterior complex destruction as in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Between December 2016 and September 2018, patients with single level degenerative spondylosis were selected to enroll in this retrospective study. A total of 21 patients that underwent OLIF and 41 patients that received MIS-TLIF were enrolled. OLIF showed significantly less blood loss and shorter surgery time compared to MIS-TLIF (p < 0.05). The improvement in segmental lordosis and coronal balance was significantly more in OLIF group than MIS-TLIF group (p < 0.05). When comparing with MIS-TLIF, OLIF was significantly better in Oswestry Disability Index (ODI) and visual analogue scale for back pain improvement at post-operative 6 months (p < 0.05). Both OLIF and MIS-TLIF are becoming mainstream procedures for lumbar degenerative-related disease, especially for spondylolisthesis. However, the indirect decompression of OLIF has shown to have less perioperative blood loss and shorter surgery time than that of MIS-TLIF. In addition, OLIF gives superior outcome in restoring segmental lordosis and coronal imbalance. While both OLIF and MIS-TLIF provide optimal clinical outcomes, upon comparison between the two techniques, the indirect decompression of OLIF seems to be a superior option in modern days.

Highlights

  • Minimal invasive spinal fusion has become popular in the last decade

  • All the Oblique lumbar interbody fusion (OLIF) cases were performed by a single surgeon from December 2016 to September 2018, and all the MIS-TLIF cases were done by another individual surgeon during the same period of time

  • Our study indicated that the OLIF group had better fusion rate at 12-months follow-up, not statistically significant; the fusion rate at 24-months follow-up was comparable between the 2 groups

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Summary

Introduction

Minimal invasive spinal fusion has become popular in the last decade. Oblique lumbar interbody fusion (OLIF) is a relatively new surgical technique and could avoid back muscle stripping and posterior complex destruction as in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). The minimally invasive technique for transforaminal lumbar interbody fusion (MIS-TLIF) was first introduced in 2002, and it has since helped improve several perioperative outcomes including operative bleeding, infection incidence, surgical injury, and days of d­ ischarge[7,8,9,10]. Another technique called oblique lateral interbody fusion (OLIF) has been becoming more popular in the twenty-first century. This retroperitoneal lumbar approach, which was first coined in 2012, helps achieve indirect decompression and preserve integrity of posterior column s­ tructure[12]

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