Comparison of Oblique Lateral Lumbar Interbody Fusion and Transforaminal Interbody Fusion for The Treatment of Degenerative Lumbar Scoliosis

doi:10.3877/cma.j.issn.2096-0263.2021.06.005

Abstract

Abstract:

Objective

To investigate the difference between oblique lateral lumbar interbody fusion(OLIF) and transforaminal interbody fusion (TLIF) for the treatment of degenerative lumbar scoliosis (DLS).

Methods

A retrospective analysis of 134 patients with DLS admitted to our hospital from February 2017 to February 2019. According to different surgical methods, they were divided into OLIF operation group (64 cases) and TLIF operation group (70 cases), the two groups of patients were compared for operation related Indicators, complications, fusion rate were compared, and visual analog scale (VAS) and Oswestry disability index (ODI) were evaluated preoperatively, 6 months, and 2 years postoperatively. The coronal position, sagittal Cobb angle, lumbar lordosis angle, sacral tilt angle, pelvic incidence angle were calculated.

Results

The operation time of the OLIF group was (243 ± 39) min, which was significantly higher than that of the TLIF group (215±29) min, (t=3.432, P=0.001). The intraoperative blood loss in the OLIF group was (411± 34) ml, Significantly lower than the control group (653 ± 42) ml, (t=4.865, P<0.001); the ODI index, VAS score, and coronal Cobb angle of the two groups were lower than that of the operation 6 months after the operation and 2 years after the operation. The sagittal Cobb angle, lumbar lordosis angle, sacral inclination angle, and pelvic angle of incidence were higher than those before surgery, but the coronal Cobb angles in the OLIF surgery group were (22.2±3.2)° at 3 months and 2 years after surgery (22.2±3.2)°, significantly higher than (20.1±2.0)°, (20.1±2.0)°, (t=4.534, t=4.798, P<0.001) in the TLIF group, 3 months after operation, 2 years postoperatively, the coronal Cobb angles in the OLIF group were (3.2 ± 0.4)° and (3.5 ± 0.3)°, which were significantly lower than the (5.5 ± 1.0)° and (5.6 ± 0.8)° in the TLIF group, (t=16.265, t=20.595, P<0.001), the lumbar lordosis angles of the OLIF operation group were (47.2±3.2)° and (46.9±2.6)° at 3 months and 2 years after operation, which were significantly higher than those of TLIF (39.2±3.2)°, (38.9±2.4)°, (t=14.602, t=18.498, P<0.001) in the operation group, the sacral inclination angles of the OLIF operation group at 3 months and 2 years after the operation were respectively (34.8±4.3)° and (34.4±4.0)° were significantly higher than (30.4±4.2)° and (30.0±3.9)° in the TLIF group, (t=5.964, t=6.494, both P<0.001).

Conclusion

Both TLIF and OLIF can obtain definite short-term curative effects in the treatment of DLS. OLIF has a slightly longer operation time, but has less trauma and better coronal and sagittal correction effects.

Key words: Oblique lumbar interbody fusion, Transforminal lumbar interbody fusion, Degenerative lumbar scoliosis

Yujun Pan, Changjiang Shi, Huaizhao Mu, Yilong Zhang. Comparison of Oblique Lateral Lumbar Interbody Fusion and Transforaminal Interbody Fusion for The Treatment of Degenerative Lumbar Scoliosis[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2021, 07(06): 345-351.

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References 21

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组别	例数	性别	LenkeSilva分型	年龄（岁）	融合节段数（个）
组别	例数	男/女	Ⅱ型/Ⅲ型	年龄（岁）	融合节段数（个）
OLIF术组	64	28/36	52/12	65±6	2.7±0.5
TLIF术组	70	30/40	54/16	66±6	2.7±0.5
统计值		χ²=0.011	χ²=0.341	t=0.895	t=0.688
P值		0.917	0.559	0.0.373	0.439
组别	例数	BMI（kg/m²）	合并高血压	合并糖尿病	融合位置
组别	例数	BMI（kg/m²）	合并高血压	合并糖尿病	L_1~4/L_2~5/L_2~4/L_3~5/L_2~3/L_3~4/L_4~5
OLIF术组	64	22.8±2.0	10	7	6/12/18/8/9/7/4
TLIF术组	70	22.9±2.1	12	9	8/15/20/13/6/5/3
统计值		t=0.364	χ²=0.056	χ²=0.117	χ²=0.103
P值		0.717	0.813	0.732	0.858

组别	例数	性别	LenkeSilva分型	年龄（岁）	融合节段数（个）
组别	例数	男/女	Ⅱ型/Ⅲ型	年龄（岁）	融合节段数（个）
OLIF术组	64	28/36	52/12	65±6	2.7±0.5
TLIF术组	70	30/40	54/16	66±6	2.7±0.5
统计值		χ²=0.011	χ²=0.341	t=0.895	t=0.688
P值		0.917	0.559	0.0.373	0.439
组别	例数	BMI（kg/m²）	合并高血压	合并糖尿病	融合位置
组别	例数	BMI（kg/m²）	合并高血压	合并糖尿病	L_1~4/L_2~5/L_2~4/L_3~5/L_2~3/L_3~4/L_4~5
OLIF术组	64	22.8±2.0	10	7	6/12/18/8/9/7/4
TLIF术组	70	22.9±2.1	12	9	8/15/20/13/6/5/3
统计值		t=0.364	χ²=0.056	χ²=0.117	χ²=0.103
P值		0.717	0.813	0.732	0.858

组别	例数	手术时间（min）	术中出血（ml）	住院天数（d）
OLIF术组	64	243±39	411±34	7.0±2.1
TLIF术组	70	215±29	653±42	7.4±2.1
t值		3.432	4.865	0.905
P值		0.001	<0.001	0.367

组别	例数	手术时间（min）	术中出血（ml）	住院天数（d）
OLIF术组	64	243±39	411±34	7.0±2.1
TLIF术组	70	215±29	653±42	7.4±2.1
t值		3.432	4.865	0.905
P值		0.001	<0.001	0.367

组别	例数	椎间融合率	并发症
组别	例数	椎间融合率	交感神经损伤症状	动脉损伤	慢性腰背痛	切口感染	总发生率
OLIF术组	64	62（96.88）	2	2	4	0	8（12.50）
TLIF术组	70	66（94.29）	0	0	8	2	10（14.29）
χ²值		0.524					0.092
P值		0.469					0.762

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