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October 11, 2025Open Access

Outcomes Comparison Between Oblique Lumbar Interbody Fusion and Minimally Invasive Transforaminal Lumbar Interbody Fusion in Low-Grade Spondylolisthesis: A Randomized Clinical Trial

Puntos clave

Both oblique lumbar interbody fusion and minimally invasive transforaminal lumbar interbody fusion significantly improved patient-reported outcomes.
The mean change in VAS back pain was −3.9, with no significant differences between the two fusion techniques over follow-up.
This randomized controlled trial involved 60 patients undergoing surgery for spondylolisthesis at L4 to L5, assessing multiple clinical and radiological outcomes.
While both procedures showed comparable effectiveness, OLIF had advantages in restoring disc height and foraminal dimensions, along with reduced blood loss.

Resumen

Background Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and oblique lumbar interbody fusion (OLIF) are widely used for treating spondylolisthesis patients, but there is no randomized controlled trial study that directly compared OLIF and MIS-TLIF. Methods Sixty patients who underwent single-level surgery at L4 to L5 were randomly allocated to the MIS-TLIF or OLIF group. Primary clinical outcomes were visual analog scale (VAS) of back and leg pain, Oswestry Disability Index (ODI) scores, and EQ-5D-5L. Secondary outcomes were radiological outcomes including disc height (DH), foraminal height (FH), foraminal area (FA), cross-sectional area of spinal canal, spinal canal diameter, and fusion rates. Results Both groups showed significant improvements in clinical outcomes from baseline to each subsequent postoperative period. Predicted mean change (95% CI) in VAS back, VAS leg, ODI scores, and EQ-5D-5L were −3.9 (−4.6 to −3.1), −5.6 (−6.2 to −5.1), −15.7 (−19.0 to −12.5), and 25.4 (21.3–29.6), respectively. Clinical differences in both groups over total follow-up were not statistically significant: VAS back −0.38 (−0.87 to 0.11); P = 0.18, VAS leg: −0.40 (−0.81 to 0.02); P = 0.08, ODI: 0.4 (−1.9 to 2.8); P = 0.7 and EQ-5D-5L: 0.1 (−1.9 to 2.2); P = 0.9. Radiological parameters significantly improved from baseline to early postoperation in both groups. Changes in DH, FH, and FA were lower in MIS-TLIF compared with OLIF. The cross-sectional area of spinal canal change was higher in MIS-TLIF compared with OLIF. Spinal canal diameter change was not different between groups. Fusion rates were similar in both groups. Conclusions Patient-reported outcomes were significantly improved in both MIS-TLIF and OLIF groups without significant differences between both procedures. OLIF demonstrated advantages in restoration of DH, FH, FA, and lower intraoperative blood loss compared with MIS-TLIF. Clinical Relevance Both MIS-TLIF and OLIF offer comparable clinical benefits for patients with single-level degenerative spondylolisthesis. However, OLIF may be preferred in cases where greater restoration of disc and foraminal dimensions and reduced intraoperative blood loss are desired. Level of Evidence 1.

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Cite This Study

Singhatanadgige et al. (Thu,) studied this question.

synapsesocial.com/papers/68ea72339f1bd4df558ced81 https://doi.org/https://doi.org/10.14444/8795

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