Oblique versus Transforaminal Lumbar Interbody Fusion in Degenerative Spondylolisthesis: A Systematic Review and Meta-analysis

Abstract

BACKGROUND: This meta-analysis compared transforaminal interbody fusion (TLIF) and oblique lumbar interbody fusion (OLIF) techniques for degenerative lumbar spondylolisthesis. AIM: The aim is to evaluate Oswestry Disability Index (ODI), Japanese Orthopedic Association Back Pain Evaluation Questionnaire, visual analog scale improvement for back and leg pain, disc height, slipped percentage, blood loss, surgical time, and complication rates in both groups. METHODS: A systematic literature search was carried out to obtain a study that compared OLIF and TLIF for degenerative lumbar spondylolisthesis. A literature search was performed using PubMed, Scopus, EuropePMC, and EBSCOHost. While the intervention was the OLIF technique, the control was the TLIF technique. The primary outcome was clinical outcome (ODI, Japanese Orthopaedic Association Back Pain Evaluation Questionnaire [JOABPEQ], visual analog scale [VAS] improvement for back, and leg pain). The Newcastle-Ottawa Scale was used to assess the quality of the studies. RESULTS: Total of 384 patients from four studies were included in this study. OLIF group was better than TLIF group in terms of disc height, slipped percentage, and blood loss. ODI, JOABPEQ, VAS improvement for back pain (standardized mean difference [SMD] 0.06 [−0.18, 0.29], p = 0.63, I2 = 0%, p = 0.87) and leg pain (SMD 0.12 [−0.36, 0.60], p = 0.63, I2 = 74%, p = 0.02), surgical time, and complication rates were similar in both groups. CONCLUSION: OLIF technique was better than TLIF technique in terms of radiologic outcome and surgical blood loss. Both techniques showed similar outcomes in clinical outcome, complication, and surgical time.