Department of Orthopedics, Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical University, 56 Jinsui Avenue, Xinxiang, 453000, Henan, China.
Sci Rep. 2024 Nov 27;14(1):29497. doi: 10.1038/s41598-024-81261-w.
Lumbar disc herniation (LDH) often necessitates surgical intervention when conservative treatments fail. Oblique Lateral Interbody Fusion (OLIF) and Transforaminal Lumbar Interbody Fusion (TLIF) are two commonly used techniques for treating LDH, each offering distinct surgical approaches. This study aimed to compare the efficacy of OLIF versus TLIF in terms of pain relief, functional outcomes, spinal alignment correction, fusion success, and postoperative recovery. A retrospective study was conducted on 133 patients who underwent either OLIF (n = 68) or TLIF (n = 65) between January 2020 and December 2022. Data on patient demographics, pain and functional outcomes (measured by Visual Analogue Scale [VAS] and Oswestry Disability Index [ODI]), radiological outcomes (sagittal and coronal Cobb angles, apical vertebra deviation), fusion and collapse rates, and postoperative recovery (ambulation time and hospitalization duration) were collected. Statistical analysis was performed using t-tests and chi-square tests, with significance set at P < 0.05. Both groups demonstrated significant postoperative improvements in pain and functional outcomes. OLIF resulted in significantly better long-term pain reduction (VAS 1.99 ± 0.67 vs. 2.29 ± 0.92, P = 0.03) and greater spinal alignment correction, particularly in sagittal Cobb angle and apical vertebra deviation (P < 0.001). The fusion rate was similar between OLIF (97.92%) and TLIF (96.61%, P = 0.56), but OLIF had a lower collapse rate (8.33% vs. 18.64%, P < 0.001). OLIF also facilitated faster postoperative recovery, with earlier ambulation and shorter hospitalization time (P < 0.001 for both). While both OLIF and TLIF are effective for treating LDH, OLIF offers superior long-term pain relief, better spinal alignment correction, reduced collapse rates, and faster recovery. These findings suggest that OLIF may be a more advantageous option for patients requiring lumbar interbody fusion.
腰椎间盘突出症（LDH）经保守治疗无效时通常需要手术干预。斜外侧椎间融合术（OLIF）和经椎间孔腰椎间融合术（TLIF）是治疗 LDH 的两种常用技术，每种技术都提供了独特的手术方法。本研究旨在比较 OLIF 与 TLIF 在缓解疼痛、功能结果、脊柱矫正、融合成功率和术后恢复方面的疗效。对 2020 年 1 月至 2022 年 12 月期间接受 OLIF（n=68）或 TLIF（n=65）治疗的 133 例患者进行回顾性研究。收集患者人口统计学资料、疼痛和功能结果（通过视觉模拟评分[VAS]和 Oswestry 残疾指数[ODI]测量）、影像学结果（矢状面和冠状面 Cobb 角、顶椎偏移）、融合和塌陷率以及术后恢复（下床活动时间和住院时间）数据。使用 t 检验和卡方检验进行统计学分析，显著性水平设为 P<0.05。两组患者术后疼痛和功能均有显著改善。OLIF 组在长期疼痛缓解方面具有显著优势（VAS 1.99±0.67 比 2.29±0.92，P=0.03），且在脊柱矫正方面，尤其是在矢状面 Cobb 角和顶椎偏移方面具有更大的优势（P<0.001）。OLIF 组（97.92%）与 TLIF 组（96.61%，P=0.56）的融合率相似，但 OLIF 组的塌陷率较低（8.33%比 18.64%，P<0.001）。OLIF 还促进了更快的术后恢复，下床活动时间更早，住院时间更短（均 P<0.001）。OLIF 和 TLIF 均能有效治疗 LDH，但 OLIF 提供了更好的长期疼痛缓解、更好的脊柱矫正、更低的塌陷率和更快的恢复。这些发现表明，OLIF 可能是需要腰椎间融合术的患者的更有利选择。
