Comparison of radiographic and clinical outcomes between ALIF, OLIF, and TLIF over 2-year follow-up: a comparative study

Abstract

Background Regarding the increasing adoption of oblique lateral interbody fusion (OLIF) for treating degenerative lumbar disorders, we aimed to evaluate whether OLIF, one of the options for anterolateral approach lumbar interbody fusion, demonstrate clinical superiority over anterior lumbar interbody fusion (ALIF) or posterior approach, represented by transforaminal lumbar interbody fusion (TLIF). Methods Patients who received ALIF, OLIF, and TLIF for symptomatic degenerative lumbar disorders during the period 2017–2019 were identified. Radiographic, perioperative, and clinical outcomes were recorded and compared during 2-year follow-up. Results A total of 348 patients with 501 correction levels were enrolled in the study. Fundamental sagittal alignment profiles were substantially improved at 2-year follow-up, particularly in the anterolateral approach (A/OLIF) group. The Oswestry disability index (ODI) and EuroQol-5 dimension (EQ-5D) in the ALIF group were superior when compared to the OLIF and TLIF group 2-year following surgery. However, comparisons of VAS-Total, VAS-Back, and VAS-Leg revealed no statistically significance across all approaches. TLIF demonstrated highest subsidence rate of 16%, while OLIF had least blood loss and was suitable for high body mass index patients. Conclusions Regarding treatment for degenerative lumbar disorders, ALIF of anterolateral approach demonstrated superb alignment correction and clinical outcome. Comparing to TLIF, OLIF possessed advantage in reducing blood loss, restoring sagittal profiles and the accessibility at all lumbar level while simultaneously achieving comparable clinical improvement. Patient selection in accordance with baseline conditions, and surgeon preference both remain crucial issues circumventing surgical approach strategy.

Treatment of refractory low back pain due to arthrosis of the lumbar spine with or without spondylolisthesis using anterior lumbar interbody fusion (ALIF)

“…In the search for evidence, a total of 2,377 studies were retrieved, 2,346 of which were inMEDLINE, 14 in EMBASE, 12 in the ClinicalTrials database, and 5 in Scholar. Probably meeting the eligibility criteria, 38 works were initially selected, which, by reading their full texts, allowed the final selection of seven publications 1 , 2 , 3 , 4 , 5 , 6 , 7 to support this evaluation ( Table 1 and Figure 1 ). The reasons for exclusion are given in Table 1 .…”

“…The ODI for pain in the leg and back outcome was included in the analysis of four studies 1 , 2 , 3 , 4 : in the 6-month follow-up, two studies 1 , 2 (1 comparing with OLIF 1 and 2 comparing with TLIF 1 , 2 ) and in the 12-month follow-up, four studies 1 , 2 , 3 , 4 (1 comparing with OLIF 1 , 3 comparing with TLIF 1 , 2 , 3 , and 1 comparing with PLIF 4 ). The results of the remaining three included studies 5 , 6 , 7 are only described ( Table 3 ) and will not be considered in the conclusions of this evaluation.…”

The Evolution of Lateral Lumbar Interbody Fusion: A Journey from Past to Present

“…Similar to XLIF, OLIF is known to restore sagittal profiles and satisfies Schwab’s criteria for proper global alignment [ 111 ]. Proper global alignment has been linked to improved quality of life for adult patients with spinal deformities, especially spondylolisthesis [ 104 , 112 , 113 , 114 , 115 , 116 , 117 ]. Ko et al measured the sagittal disc angle (SDA), coronal disc angle (CDA), mean disc height (MDH), and intervertebral foramen height (FH) directly after the XLIF and OLIF surgery, and one year postoperatively.…”