To evaluate the clinical effect of oblique lumbar interbody fusion (OLIF) combined with spinal endoscopy decompression for the treatment of degenerative lumbar disease.

Patients with lumbar degenerative disease who underwent OLIF combined with spinal endoscopy at our hospital between October 2015 and May 2020 were retrospectively analysed (observation group). The results were compared with patients who underwent minimally invasive TLIF during the same period (control group). Operative time, blood loss, postoperative stay, hospital costs and complications were recorded. VAS and ODI scores were used to assess the clinical efficacy of surgery. Radiological parameters were measured by X-ray or three-dimensional CT.

All 59 patients were followed up. The observation group consisted of 26 cases with a mean follow-up of (24.2±7.8) months.The control group consisted of 33 cases with a mean follow-up of (24.7±8.1) months.The observation group had lower intraoperative blood loss, postoperative drainage volume and average postoperative hospital stay compared to the control group. However, operative time and average hospital costs were higher in the observation group than in the control group (P<0.05). The postoperative incisional pain VAS score in the observation group [(2.0±1.5) points] was significantly lower than that in the control group [(4.0±1.4) points, P<0.001)]. Repeated measures analysis of variance (ANOVA) was performed to examine back pain VAS scores, leg pain VAS scores, and ODI index across groups and time points. The results showed no significant differences between groups, significant differences between time points (P<0.05) and no interaction between groups and time points. The VAS scores of back pain, VAS scores of leg pain and ODI index at each time point after surgery were significantly lower in both groups compared to pre-surgery scores (P<0.05) and gradually decreased over time. The size and height of the intervertebral foramen, as well as the height of the intervertebral space, underwent analysis through repeated measures ANOVA across time points and groups. Results indicate statistically significant differences between time points and significant interaction effects between groups and time points for all three parameters (P<0.05). Statistically significant differences were observed between the groups in terms of intervertebral space height and intervertebral foramen height (P<0.05), but not in terms of intervertebral foramen size. Further analysis revealed that the intervertebral space height, intervertebral foramen height and size were consistently greater in the observation group than in the control group at all time points except preoperative (P<0.05). Specifically, at 1 year after surgery, the intervertebral space height, foramen height, and size in the observation group were [(13.0±2.2)mm, (19.5±0.3)mm, (158.4±4.4)mm²], which were significantly greater than those in the control group [(10.0±2.4)mm, (18.1±0.2)mm, (142.0±3.9)mm², P<0.05]. Furthermore, in the observation group, the intervertebral space height, intervertebral foramen height and size were significantly larger at all time points after surgery compared to preoperative (P<0.05). However, there were no significant differences in fusion rate and complication rate between the two groups.

The combination of OLIF with spinal endoscopic decompression surgery is minimally invasive and effective, and can also effectively restore the height of the intervertebral space and the size of the intervertebral foramen, providing a new option for the treatment of lumbar degenerative disease.