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.

Objective: Although widely used in clinical practice, vertebral augmentation procedure (VAP) for osteoporotic vertebral compression fracture (OVCF) is not supported. Recently, the effect of recombinant human parathyroid hormone (1-34) (rhPTH) has been paid great attention for its efficacy in anti-osteoporosis and bone union. This study aims to explore the outcome of rhPTH on acute OVCF and compare it with VAP to clarify its therapeutic advantages. Methods:The retrospective study comprised 71 acute OVCF patients from January 2015 to March 2020: 22 received rhPTH treatment (rhPTH group) and 49 underwent VAP (VAP group). The rhPTH group was 15 women and seven men with an average of 76.18 years, and the VAP group were 35 women and 14 men with an average of 73.63 years. The thoracic/lumbar vertebrae were 14/8 in the rhPTH group and 29/20 in the VAP group. The average follow-up period was 14.05 months in the rhPTH group and 13.82 months in the VAP group. The two groups were assessed regarding the visual analog score (VAS), Oswestry Disability Index (ODI), OVCF bone union, bone mineral density (BMD), kyphotic angle (KA), anterior and posterior border height (ABH and PBH, respectively), adverse events and the health-related quality of life assessed by short form-36 health survey scores (SF-36). Categorical variables were analyzed by chisquare test and continuous variables between groups were analyzed by independent samples t-test or Mann-Whitney U test according to the normality.Results: During the follow-up, the VAS was significantly lower in the rhPTH group than in the VAP group at month 3 (0.39 AE 0.6 vs 0.68 AE 0.651) (p = 0.047), month 6 (0.45 AE 0.60 vs 2.18 AE 1.22) (p < 0.001), and month 12 (0.45 AE 0.60 vs 2.43 AE 1.49) (p < 0.001). At month 12, the ODI was significantly lower in the rhPTH group (18.59 AE 3.33%) than in the VAP group (28.93 AE 16.71%) (p < 0.001). Bone bridge was detected on sagittal computed tomography images of all fractured vertebrae in the rhPTH group. The BMD was significantly higher in the rhPTH group (87.66 AE 5.91 Hounsfield units [HU]) than in the VAP group (68.15 AE 11.32HU) (p < 0.001). There were no significant differences in the changes in KA, ABH, and PBH between groups (all p > 0.05). The incidence of new OVCF was significantly lower in the rhPTH group than in the VAP group (p = 0.042). All scores of SF-36 were significantly higher in the rhPTH group than in the VAP group (all p < 0.05). Conclusion:In acute OVCF patients, rhPTH was better than VAP in increasing spinal BMD to promote OVCF healing, reduce new OVCF, and improve back pain, physical ability, and health-related quality of life.