Comparisons of oblique lumbar interbody fusion and transforaminal lumbar interbody fusion for degenerative spondylolisthesis: a prospective cohort study with a 2-year follow-up

Abstract

ObjectiveThis study aimed to compare the clinical outcomes between oblique (OLIF) and transforaminal lumbar interbody fusion (TLIF) for patients with degenerative spondylolisthesis during a 2-year follow-up.MethodsPatients with symptomatic degenerative spondylolisthesis who underwent OLIF (OLIF group) or TLIF (TLIF group) were prospectively enrolled in the authors’ hospital and followed up for 2 years. The primary outcomes were treatment effects [changes in visual analog score (VAS) and Oswestry disability index (ODI) from baseline] at 2 years after surgery; these were compared between two groups. Patient characteristics, radiographic parameters, fusion status, and complication rates were also compared.ResultsIn total, 45 patients were eligible for the OLIF group and 47 patients for the TLIF group. The rates of follow-up were 89% and 87% at 2 years, respectively. The comparisons of primary outcomes demonstrated no different changes in VAS-leg (OLIF, 3.4 vs. TLIF, 2.7), VAS-back (OLIF, 2.5 vs. TLIF, 2.1), and ODI (OLIF, 26.8 vs. TLIF, 30). The fusion rates were 86.1% in the TLIF group and 92.5% in the OLIF group at 2 years (P = 0.365). The OLIF group had less estimated blood loss (median, 200 ml) than the TLIF group (median, 300 ml) (P < 0.001). Greater restoration of disc height was obtained by OLIF (mean, 4.6 mm) than the TLIF group (mean, 1.3 mm) in the early postoperative period (P < 0.001). The subsidence rate was lower in the OLIF group than that in the TLIF group (17.5% vs. 38.9%, P = 0.037). The rates of total problematic complications were not different between the two groups (OLIF, 14.6% vs. TLIF, 26.2%, P = 0.192).ConclusionOLIF did not show better clinical outcomes than TLIF for degenerative spondylolisthesis, except for lesser blood loss, greater disc height restoration, and lower subsidence rate.

Fusion rate and complications of oblique lumbar interbody fusion and transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases: a meta-analysis

“…After further obtaining the abstracts and full texts of 30 studies, 12 studies were excluded because 9 studies had no relevant indicators, and 3 studies did not meet the criteria for patient inclusion. Finally, 18 studies ( 4 – 21 ) were included in the meta-analysis. The screening process is displayed in Figure 1 .…”

“…Fusion rates were reported in 11 studies ( 4 , 5 , 7 , 8 , 10 , 12 , 14 , 15 , 17 , 18 , 21 ), and a total of 948 patients, of whom 466 belonged to the OLIF group and 482 belonged to the TLIF group. The heterogeneity between the studies was not significant ( I 2 = 0%, P = 0.44); thus, the FEM was used for the combined analysis.…”

“…A total of six studies ( 5 , 8 , 9 , 12 , 16 , 21 ) reported DH and included 541 patients, of whom 266 belonged to the OLIF group and 275 belonged to the TLIF group. There was significant heterogeneity among the studies ( I 2 = 60%, P = 0.03), and further analysis showed that the surgery type was the influencing factor of heterogeneity.…”

“…A total of 11 studies ( 4 , 6 , 8 , 9 , 12 – 16 , 19 , 21 ) reported LOS and included 897 patients, of whom 433 belonged to the OLIF group and 464 belonged to the TLIF group. The heterogeneity between the studies was significant ( I 2 = 89%, P < 0.001).…”