Comparison of clinical outcomes and spino-pelvic sagittal balance in degenerative lumbar spondylolisthesis: Minimally invasive oblique lumbar interbody fusion (OLIF) versus transforaminal lumbar interbody fusion (TLIF)

Abstract

Spino-pelvic sagittal parameters are closely related to the lumbar degenerative diseases. The present study aims to compare clinical results and spino-pelvic sagittal balance treated with oblique lumbar interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF) in patients with degenerative lumbar spondylolisthesis at single segment.We retrospectively reviewed and compared 28 patients who underwent OLIF (OLIF group) and 35 who underwent TLIF (TLIF group). Radiological results were evaluated with disc height (DH), foraminal height (FH), fused segment lordosis (FSL), lumbar lordosis (LL), pelvic tilt (PT), pelvic incidence (PI), and sacral slope (SS). Clinical results were evaluated with the Oswestry Disability Index (ODI) and VAS for back and leg pain.The OLIF group showed higher improvement of DH and FH than the TLIF group at all time points after surgery (P < .05). No significant differences were found in PT, PI, and SS between the 2 groups (P > .05). Significant restoration of spino-pelvic sagittal balance was observed in the 2 groups after surgery. Significant differences in postoperative lumbar lordosis and fused segment lordosis were found between the 2 groups (P < .05). Significant difference in the improvement of symptoms was observed between the 2 groups. The OLIF group had lower VAS scores for back pain and ODI compared after surgery (P < .05).It can be concluded that there are exactly differences in improvement of radiographic parameters between 2 approaches, which confirmed that OLIF is better in restoring spinal alignment. Besides, due to the unique minimally invasive approach, OLIF did exhibit a greater advantage in early recovery after surgery.