Safety and Efficacy of Oblique Lateral Interbody Fusion (OLIF) in the Treatment of Degenerative Lumbar Spinal Stenosis

Abstract

Background: Lumbar spinal stenosis is a common degenerative disease of the elderly and adequate decompression is the most critical determinant for the surgical management of degenerative DLCS. Objective: To compare and analyse the safety and effectiveness of the oblique lateral interbody fusion (OLIF) technique and conventional lumbar posterior laminar decompression for lumbar spinal stenosis (DLCS). Methods: Sixty-eight patients over 60 years of age with lumbar spinal stenosis were included from October 2019 to November 2021, and were divided into the OLIF group and the conventional decompression group (conventional posterior laminar decompression and internal fixation) according to their treatment methods. The general data, operation time, intraoperative bleeding, hospital stay, surgical complications, clinical efficacy evaluated by modified MacNab criteria, and the patients' preoperative and final postoperative pain visual analogue scale scores (VAS) and Oswestry dysfunction index (ODI) were statistically analysed in the two groups. Results: There was no statistically significant difference in age, gender, BMI, duration of disease, lesion segment, VAS score and ODI index between the two groups of patients before treatment (p > 0.05). After treatment, the OLIF group had a greater advantage in terms of operative time, intraoperative bleeding, length of hospital stay and operative complications than the conventional decompression group, with statistical significance between the groups (P < 0.05). Compared with the pre-treatment period, the VAS scores and ODI scores of patients in both groups showed significant improvement (P < 0.05). A comparison between the two groups revealed a statistically significant difference (P < 0.05) in the improvement of VSA and ODI scores at the end of the postoperative period in the OLIF group compared with the conventional decompression group. The clinical efficacy of the two groups evaluated by the modified MacNab criteria at the final follow-up was 90.625% in the OLIF group and 80.55% in the conventional decompression group, respectively, with a statistical difference (P < 0.05). Conclusion: Compared with traditional decompression fusion, the use of OLIF technique can safely and effectively decompress DLCS, and also has many advantages such as less trauma, less bleeding, shorter operation time and hospital stay, and lower postoperative complications, which is worthy of clinical preference.