Comparison of outcomes between Oblique Lumbar Interbody Fusion and MED-Assisted Minimally Invasive Transforaminal Lumbar Interbody Fusion in single-level lumbar spondylosis

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Background: For Lumbar degenerative spondylolisthesis, lumbar fusion surgery is usually one of the treatment options after conservative treatment has failed. This retrospective study compared the recent clinical efficacy of Oblique Lumbar interbody Fusion (OLIF) and Microendoscopic Discectomy combine Minimally Invasive Transforaminal Lumbar Interbody Fusion (MED-assisted MIS-TLIF) in the treatment of lumbar single-level spondylolisthesis. Methods: A total of 55 patients with degenerative lumbar spondylolisthesis who underwent OLIF or MED-assisted MIS-TLIF between February 2019 and February 2021 were enrolled. Operating time, intra-operative bleeding and post-operative drainage were recorded to evaluate the intraoperative performance. The oswestry disability index (ODI) and visual analog scale (VAS) for back and leg pain were used to evaluate the clinical outcomes. Lumbar lordosis (LL), fused segmental lordosis (FSL) and disc height (DH) were measured preoperatively, three days postoperatively, 3 months and 12 months postoperatively. Fusion status (FS) and cage subsidence (CS) were assessed at final follow-up postoperatively. Results were analyzed statistically.Results: In this study, patients were divided into the OLIF group (35 cases) and the MIS-TLIF group (20 cases). No statistically significant difference in preoperative indicators between groups. Intraoperative performance of the OLIF group was better than that of the MIS-TLIF group. At the immediate postoperative, the VAS was 3.54±1.12 in the OLIF group and 4.25±1.02 in the MIS-TLIF group(P=0.024). There was no significant difference in the VAS and ODI score at subsequent follow-up. Comparison of radiographic indicators showed that there was a significant difference in the DH between groups at post-operative and final follow-up(12.11±1.83 mm vs 11.04±1.26 mm, P = 0.024; 11.98±1.81 mm vs 10.88±1.27 mm, P =0.011). At the last follow-up, the fusion rate and CS in the OLIF group and the MIS-TLIF group was not statistically significant (91.43% vs 75%, P=0.206; 8.57% vs 15%, P=0.775).Conclusion: OLIF has advantages in terms of intraoperative performance and postoperative recovery. In terms of clinical presentation, both two groups have excellent short-term outcomes for patients with lumbar spondylolisthesis. Further follow up is required for long term outcome.