Efficacy and radiographic analysis of oblique lumbar interbody fusion for degenerative lumbar spondylolisthesis

Menghui Wu,Yong Shen,Jia Li,Mengxin Zhang,Xufeng Ding,Guimiao Li,Dongxu Qi

doi:10.1186/s13018-019-1416-2

Abstract

BackgroundTo compare the clinical efficacy and radiographic analysis of oblique lumbar interbody fusion (OLIF) and traditional posterior lumbar interbody fusion (PLIF) in treating degenerative lumbar spondylolisthesis (DLS).MethodsGrade I DLS patients admitted to the Third Hospital of Hebei Medical University were retrospectively reviewed. In sum, 78 patients that underwent OLIF (n = 31) and PLIF (n = 47) treatment of DLS were recruited. Clinical data including clinical and radiological evaluations were collected pre-operatively and at each follow-up. Japanese Orthopaedic Association (JOA) scores, Oswestry Disability Index (ODI), lumbar lordosis (LL), disc height (DH), and fusion rates were compared between the OLIF and PLIF groups.ResultsThe operation time for both groups was 131.3 ± 14.6 min in the OLIF group and 156.9 ± 37.4 min in the PLIF group (P < 0.001). The intraoperative blood loss was 163.6 ± 63.9 ml in the OLIF group and 496.8 ± 122.6 ml in the PLIF group (P < 0.001). The length of the surgical incision was 4.63 ± 0.57 cm in the OLIF group and 11.83 ± 1.37 cm in the PLIF group (P < 0.001). The number of intraoperative and post-operative complications for both groups was 10 in the OLIF group and 20 in the PLIF group. Significant clinical improvement (P < 0.05) was observed in JOA scores and ODI when comparing pre-operative evaluation and final follow-up. After statistical analysis, there was no significant difference in the preoperative JOA scores between the two groups. There was no significant difference when comparing pre-operative LL and DH for either group. Post-operative reexamination was improved as compared to pre-operative exams. And the improvement of DH was better in the OLIF group as compared to the PLIF group.ConclusionsFor DLS patients, both OLIF and PLIF can achieve good results. Furthermore, OLIF displays marked advantages including smaller surgical incisions, shorter anesthesia times, decreased intraoperative blood loss, and post-operative pain better relieved.

Highlights

Lumbar spondylolisthesis (LS) is a common chronic disease of the human population, with an incidence of about 6% [1]
The cause of LS can be divided into degenerative, isthmic fissure, dysplasia, traumatic, and pathological, among which degenerative lumbar spondylolisthesis
oblique lumbar interbody fusion (OLIF) represents a new surgery technique that was originally introduced by Mayer [3] in 1997, which is a minimally invasive oblique lateral retroperitoneal technique, which was further improved by Silvestre [2]

Summary

Introduction

Lumbar spondylolisthesis (LS) is a common chronic disease of the human population, with an incidence of about 6% [1]. The cause of LS can be divided into degenerative, isthmic fissure, dysplasia, traumatic, and pathological, among which degenerative lumbar spondylolisthesis (DLS) is the most common. The surgical plan typically includes posterior lumbar fusion, lumbar posterolateral fusion, posterior lumbar interbody fusion (PLIF), oblique lateral interbody fusion (OLIF) [2], and other additional surgical interventions. OLIF represents a new surgery technique that was originally introduced by Mayer [3] in 1997, which is a minimally invasive oblique lateral retroperitoneal technique, which was further improved by Silvestre [2]. To compare the clinical efficacy and radiographic analysis of oblique lumbar interbody fusion (OLIF) and traditional posterior lumbar interbody fusion (PLIF) in treating degenerative lumbar spondylolisthesis (DLS)

Methods

Results

Discussion

Conclusion