Objective To compare the clinical efficacy of endoscope-assisted oblique lumbar interbody fusion (Endo-OLIF) with posterior lumbar interbody fusion (PLIF) in the treatment of lumbar degenerative diseases. Methods A retrospective analysis was conducted on 62 patients with lumbar degenerative diseases treated at Hebei General Hospital between January 2020 and December 2023. According to the surgical procedure, they were divided into an Endo-OLIF group (30 cases) and a PLIF group (32 cases). The two groups were compared in terms of baseline characteristics, operative time, intra-operative blood loss, post-operative drainage volume, length of hospital stay, visual analogue scale (VAS) scores, Oswestry Disability Index (ODI), fusion rate, cage subsidence rate, complication rate, and relevant imaging parameters (disc height, lumbar lordosis angle, fused-segment lordosis angle, and dural sac area). Results There were no significant differences between the two groups in baseline characteristics such as sex, age, affected segment, comorbidities, or body-mass index (BMI) ( P 0.05). The Endo-OLIF group demonstrated significantly shorter operative time, less intra-operative blood loss, lower post-operative drainage, shorter hospital stay, and lower early post-operative VAS and ODI scores than the PLIF group ( P 0.05).However, VAS and ODI scores at 1 year post-operatively showed no significant inter-group difference ( P 0.05). Cage fusion and subsidence rates did not differ significantly between the two groups ( P 0.05). There was no statistically significant difference in the incidence of complications between the two groups ( P 0.05). Restoration of disc height, lumbar lordosis, and segmental lordosis was significantly better in the Endo-OLIF group ( P 0.05). Conclusions The Endo-OLIF technique achieves direct and indirect spinal-canal decompression and restores segmental lumbar lordosis without disrupting the posterior osseous framework or the muscular-ligamentous complex, thereby expanding the surgical indications of conventional OLIF. Both procedures yield satisfactory clinical outcomes for lumbar degenerative diseases; however, the Endo-OLIF approach offers the advantages of minimal invasiveness, reduced blood loss, significantly lower early post-operative VAS scores, better restoration of lumbar physiological curvature, faster recovery, and a lower risk of neurological injury. Based on these limited but promising cases, this technique warrants broader clinical application and long-term follow-up.
Han et al. (Thu,) studied this question.