Objective

Although oblique lateral interbody fusion (OLIF) utilizes the similar approach in anterior lumbar interbody fusion (ALIF), OLIF is essentially a lateral lumbar interbody fusion (LLIF). Therefore, OLIF may have advantages in LLIF that the lateral cage can achieve greater restoration of the disc height and angle. We aimed to compared the surgical outcomes between OLIF and ALIF.

Methods

This study involved 47 consecutive patients who underwent a single-level OLIF and 45 consecutive patients who underwent a single-level ALIF at L2-L5 levels. Radiological measurements included the changes of anterior/posterior disc height, coronal/sagittal disc angle, foramen cross-sectional area (CSA), cage position from the anterior margin of the lower vertebra, fusion rate, and cage subsidence using the serial radiographs and computed tomography preoperatively and at the postoperative 1-year follow-up. Clinical outcomes were assessed by visual analog scale (VAS) for back/leg pain, Oswestry disability index (ODI), and the occurrence of perioperative complications.

Results

The baseline radiological and clinical parameters were similar between the OLIF and ALIF groups (all P > 0.05). At postoperative 1 year, the mean anterior disc height was higher in the OLIF group than the ALIF group (11.4 ± 1.9 mm vs. 9.6 ± 2.6 mm, P = 0.021). The mean sagittal disc angle was also greater in the OLIF group than the ALIF group (10.9 ± 4.4° vs. 8.9 ± 5.8°, P < 0.001). The mean cage position was 5.8 ± 2.1 mm in the OLIF group and 8.7 ± 2.3 mm in the ALIF group (P <  0.001). There was no difference in the postoperative changes of coronal disc angles, foramen CSA, fusion rate, cage subsidence, VAS for back/leg pain, ODI, and the occurrence of perioperative complications between the OLIF and ALIF groups (all P > 0.05).

Conclusions

OLIF showed a greater increase in disc height and segmental lordosis than ALIF with comparable complications. OLIF is a meaningful progress from ALIF.

中文翻译：

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斜外侧椎间融合（OLIF）与前路腰椎椎间融合（ALIF）的手术效果比较

客观的

虽然斜外侧椎间融合（OLIF）在前路腰椎椎间融合（ALIF）中采用了类似的方法，但OLIF本质上是一种外侧腰椎椎间融合（LLIF）。因此，OLIF 可能在 LLIF 中具有优势，即侧向笼可以实现更大的椎间盘高度和角度的恢复。我们旨在比较 OLIF 和 ALIF 之间的手术结果。

方法

这项研究涉及 47 名连续接受单级 OLIF 的患者和 45 名连续接受 L2-L5 水平单级 ALIF 的患者。放射学测量包括前/后椎间盘高度、冠状/矢状椎间盘角度、孔横截面积（CSA）、下椎体前缘的融合器位置、融合率和融合器下沉的变化，使用连续 X 线片和计算术前断层扫描，术后 1 年随访。临床结果通过视觉模拟量表 (VAS) 评估背部/腿部疼痛、Oswestry 残疾指数 (ODI) 和围手术期并发症的发生率。

结果

OLIF 组和 ALIF 组的基线放射学和临床参数相似（均P  > 0.05）。术后 1 年，OLIF 组的平均前椎间盘高度高于 ALIF 组（11.4 ± 1.9 mm vs. 9.6 ± 2.6 mm，P =  0.021）。OLIF 组的平均矢状盘角度也大于 ALIF 组（10.9 ± 4.4° 对 8.9 ± 5.8°，P  < 0.001）。OLIF 组的平均笼位置为 5.8 ± 2.1 mm，ALIF 组为 8.7 ± 2.3 mm ( P <  0.001)。OLIF组和ALIF组术后冠状椎间盘角度、孔CSA、融合率、融合器下沉、背/腿疼痛VAS、ODI、围手术期并发症发生率无差异（均P > 0.05)。

结论

与 ALIF 相比，OLIF 的椎间盘高度和节段性前凸增加更大，并发症相当。OLIF 是 ALIF 的一个有意义的进步。