Oblique lateral interbody fusion combined with Wiltse approach pedicle screw fixation for the treatment of single-level Degenerative Lumbar Spondylolisthesis: A retrospective study

Abstract

Background: The study aimed to explore the efficacy of oblique lateral interbody fusion (OLIF) combined with Wiltse approach pedicle screw fixation in the treatment of single-level degenerative lumbar spondylolisthesis（DLS）.Methods: This is a retrospective study. The study enrolled 54 patients with single-level DLS who were treated at the Affiliated Jiangnan Hospital of Zhejiang Chinese Medical University from May 2018 to June 2020. (OLIF group) 24 cases operated using OLIF combined with Wiltse approach pedicle screw fixation, and (PLIF group) 30 cases operated by PLIF. The primary outcome measures were visual analog scale (VAS) pain scores, Oswestry dysfunction index (ODI), and the lower lumbar spine anterior convexity angle. The secondary outcome measures were operation time, intraoperative blood loss, postoperative drainage, hospitalized days, intervertebral space height, and postoperative complications. Results: All patients were followed up for 12-20 months, with a mean of 16.2 months. There were significant differences in VAS (2.63±0.58 vs 3.57±0.63, P<0.001) and ODI (9.67±0.92 vs 10.63±1.40, P<0.05) between the OLIF group and PLIF group on postoperative days (PODs) 1–3. However, the differences in VAS and ODI between the two groups were not significant at 6 months postoperatively. And there was a significant decrease in VAS (2.63±0.58 vs 1.08±0.28, P<0.05) and ODI (3.57±0.63 vs 1.10±0.31, P<0.05) in both groups in the PODs 1–3 and 6-month postoperative comparisons. OLIF group showed better intervertebral space height and the lower lumbar spine anterior convexity angle scores on PODs1–3 and at 6 months postoperatively.Conclusion: OLIF combined with the Wiltse approach pedicle screw fixation can achieve good short-term clinical results in the treatment of single-level DLS. This surgical approach is less invasive, promotes early functional recovery, shortens hospitalization time, and improves the quality of life.

Outcomes of Oblique Lateral Interbody Fusion for Adult Spinal Deformity: A Systematic Review and Meta-Analysis

“…A total of 16 studies [13][14][15][18][19][20][21][22][23][24][25][26][27][28][29][30] involving 519 patients underwent OLIF combined with posterior or lateral fixation with or without posterior decompression and PCO were included in the present meta-analysis. All included studies were assessed as good according to the NHLBI quality assessment tool.…”

“…Fifteen studies [13][14][15][18][19][20][21][22][23][24][25][26][27][28][29] involving 491 patients reported gender (145 males and 346 females) and age (mean 67.6 years, 20-86). The mean follow-up of 434 patients in 13 studies [13][14][15][18][19][20][21][22]24,[27][28][29][30] was 22 months (3-64). The mean hospital stay of 135 patients in 4 studies 13,22,23,30 was 6.3 days.…”

“…The mean hospital stay of 135 patients in 4 studies 13,22,23,30 was 6.3 days. The mean OLIF levels of 370 patients in 12 studies 14,15,[18][19][20][21][22][23][24][25]27,28 was 3.1 segments (1-6, T12-S1). The mean total fusion levels of 491 patients in 15 studies [13][14][15][18][19][20][21][22][23][24][25][26][27][28][29] was 4.9 segments (1-15, T4-S1).…”

“…The mean OLIF levels of 370 patients in 12 studies 14,15,[18][19][20][21][22][23][24][25]27,28 was 3.1 segments (1-6, T12-S1). The mean total fusion levels of 491 patients in 15 studies [13][14][15][18][19][20][21][22][23][24][25][26][27][28][29] was 4.9 segments (1-15, T4-S1). The mean fixation levels of 146 patients in 4 studies 14,18,20,27 was 7.2 segments (2-16, T3-S2).…”

“…Mean difference of all clinical outcomes was equal to the preoperative mean value of clinical outcomes minus the postoperative mean value of clinical outcomes. Thirteen studies [13][14][15][18][19][20][22][23][24][27][28][29][30] involving 448 patients reported the VAS-back scores with a mean difference of 5.11 (95%CI, 4.40-5.82). Six studies 14,18,24,[27][28][29] involving 235 patients reported the VAS-leg scores with a mean difference of 4.97 (95%CI, 3.69-6.24).…”