Application of Oblique Lumbar Interbody Fusion augmented with lateral vertebral screw for Adjacent Segment Disease: a retrospective study

Abstract

Purpose: To evaluate the radiographic and clinical outcomes of oblique lumbar interbody fusion (OLIF) augmented with lateral vertebral screw fixation as revision surgery in adjacent segmental disease (ASD) treatment compared to transforaminal lumbar interbody fusion (TLIF) reoperation. Methods: A retrospective study was conducted in the orthopedic department of Dushu Lake Hospital affiliated to Suzhou University from January 2019 to June 2023. Thirty patients with ASD underwent single segmental OLIF augmented with lateral vertebral rod-screw fixation, and another thirty-two individuals had extended TLIF surgery as a revision surgery. All patients’ baseline conditions were evaluated. The duration of the operation, intraoperative blood loss, and length of hospital stay were compared between the two groups. Radiographic and clinical outcomes were also evaluated by intervetebral disc height (IDH), intervetebral foraminal height (IFH), intervetebral foraminal area (IFA), crosssectional area of the spinal canal (CSA), thickness of ligmentum flavum (TL), Oswestry Disability Index (ODI), and visual analog scale (VAS). Results: The duration of operation (63.06 ± 8.02 min vs. 150.30 ± 7.20 min, respectively; P <0.001) and intraoperative blood loss (66.66 ± 13.15 ml vs. 311.10 ± 40.83 ml, respectively; P <0.001) were significantly lower than those in the TLIF group. The hospital stay (6.03 ± 0.61 days vs. 12.91 ± 0.73 days, respectively; P <0.001) was also significantly shorter than that in the TLIF group. Both groups have shown a significant decrease in ODI and VAS scores after the procedure (P <0.001). But the ODI scores (11.93 ± 5.03 vs. 15.44 ± 3.65; P =0.0018) and VAS (back and leg) were lower in the OLIF group at last follow-up. In the OLIF group, all radiographic parameters have improved after the surgery. Conclusion: OLIF augmented with lateral vertebral rod-screw fixation may have been found to be a safer, faster, and more effective way to treat ASD based on our early clinical and radiographic outcomes of this study.