The Effect of Oblique Lumbar Interbody Fusion Compared with Transforaminal Lumbar Interbody Fusion Combined with Enhanced Recovery after Surgery Program on Patients with Lumbar Degenerative Disease at Short-Term Follow-Up.

Huiying Yang,Xuesheng Jiang,Wenxiang Chen,Shunwu Fan,Fabiano Bini

doi:10.1155/2021/5806066

Abstract

Purpose Oblique lumbar interbody fusion (OLIF) approach has been increasingly frequently performed in recent years. However, neither studies of OLIF approach nor the researches of the application of enhanced recovery after surgery (ERAS) in spinal surgery are relatively rare. Here, our study is aimed at investigating the therapeutic effects of the application of OLIF compared with transforaminal lumbar interbody fusion (TLIF) approach combined with ERAS in dealing with this disorder at short-term follow-up. Material and Methods. Thirty-eight patients who undergone OLIF and forty patients who undergone TLIF with pedicle screws were included in our study. The concept of ERAS was applied in the perioperative period of the patients. Preoperative and postoperative laboratory test indexes of blood were examined and evaluated in all individuals. Visual analogue scale (VAS), Oswestry disability index (ODI), and Clinical Symptom Score of the Japanese Orthopaedic Association (JOA) were used in preoperative evaluation and postoperative follow-up. Satisfaction survey was also performed after surgery. Result The postoperative results of red blood count, C-reaction protein, D-dimer, and albumin were still within the reference ranges in most of the patients. It was shown that objective evaluations including VAS score, ODI index, and JOA score were significantly improved after OLIF and TLIF surgery. The follow-up of 6 months after surgery showed that VAS, ODI, and JOA were improved more in the OLIF group than that in the TLIF group. The overall satisfaction (satisfied and very satisfied) was 95% and 97.4% in the TLIF group and the OLIF group, respectively, and there was no difference between the two groups. Conclusion This study indicated that OLIF and TLIF approach were both rather effective therapies for patients with lumbar degenerative diseases. The effect of OLIF procedure could be better than TLIF procedure in the early stage after surgery.

Highlights

Lumbar degenerative disease happens mainly on account of gradual degeneration of intervertebral disk with increasing age, which consists of lumbar disc herniation, lumbar spinal stenosis, lumbar degenerative slippage, lumbar spondylolysis with or without vertebral slippage, lumbar degenerative scoliosis, and discogenic lumbago [1, 2]
Lumbar interbody fusion (LIF) is commonly performed by using five main approaches consisting of posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), lateral lumbar interbody fusion (LLIF), oblique lumbar interbody fusion (OLIF), and anterior lumbar interbody fusion (ALIF) [6]
This study investigated the curative effects of patients with lumbar degenerative diseases by applying OLIF or TLIF approach combined with enhanced recovery program

Summary

Introduction

Lumbar degenerative disease happens mainly on account of gradual degeneration of intervertebral disk with increasing age, which consists of lumbar disc herniation, lumbar spinal stenosis, lumbar degenerative slippage, lumbar spondylolysis with or without vertebral slippage, lumbar degenerative scoliosis, and discogenic lumbago [1, 2]. More and more patients need surgery, and the costs of surgery are continuously increased [3]. It leads to heavy economic and social burdens by surgical treatment. Lumbar interbody fusion (LIF) is a determined treatment for lumbar degenerative disease [5]. LIF is commonly performed by using five main approaches consisting of posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), lateral lumbar interbody fusion (LLIF), oblique lumbar interbody fusion (OLIF), and anterior lumbar interbody fusion (ALIF) [6].

Methods

Results

Conclusion