Yongjun Tong, Chudi Fu, Qibin Zhang, Bao Huang, Changjiang Ou, Xuyang Zhang, Junhui Liu, Shunwu Fan, Fengdong Zhao
Department of Orthopedics, Zhejiang Hospital, Hangzhou, China.
Department of Orthopaedics, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Global Spine J. 2024 Dec 17:21925682241310151. doi: 10.1177/21925682241310151.
Retrospective cohort study.
Limited clinical literature addresses potential differences in fusion features between Oblique lumbar interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF). We observed that in OLIF, there are many cases with the appearance of extra-vertebral bone bridges (EVB), a phenomenon distinct from traditional TLIF fusion. This study aims to compare fusion rates, cage subsidence, and fusion features among OLIF stand-alone (OLIF-SA), OLIF with posterior pedicle screw fixation (OLIF-PS), and TLIF.
We retrospectively analyzed 198 patients (311 levels) undergoing OLIF-SA, OLIF-PS, or TLIF from July 2017 to June 2021. We assessed patient-reported outcomes, cage subsidence, fusion rate, and fusion features on CT scans.
The study included 64 OLIF-SA patients (102 levels), 60 OLIF-PS patients (99 levels), and 74 TLIF patients (110 levels). Cage settling rates were 33.3% (OLIF-SA), 17.2% (OLIF-PS), and 32.8% (TLIF), with significant differences between OLIF-PS and TLIF ( < 0.05). Cage subsidence rates showed no significant difference: 11.8% (OLIF-SA), 9.1% (OLIF-PS), and 12.7% (TLIF) ( > 0.05). Fusion rates were 100% (OLIF-SA), 97.0% (OLIF-PS), and 96.4% (TLIF) ( = 0.167). Lateral fusion rates significantly differed: 49.0% (OLIF-SA), 30.3% (OLIF-PS), and 10.9% (TLIF) ( < 0.001). Preoperative osteophytes strongly promote lateral fusion ( < 0.001). VAS and ODI scores improved significantly post-surgery ( < 0.01).
OLIF-SA, OLIF-PS, and TLIF surgeries show satisfactory results with comparable fusion rates. Notably, distinctive differences exist in fusion features between OLIF and TLIF surgeries, with lateral fusion more prevalent in OLIF, particularly in OLIF-SA surgeries.
回顾性队列研究。
关于斜外侧腰椎椎间融合术（OLIF）与经椎间孔腰椎椎间融合术（TLIF）融合特征的潜在差异，临床文献有限。我们观察到，在OLIF手术中，有许多病例出现了椎体外骨桥（EVB），这是一种与传统TLIF融合不同的现象。本研究旨在比较单纯OLIF（OLIF-SA）、OLIF联合后路椎弓根螺钉固定（OLIF-PS）以及TLIF的融合率、椎间融合器下沉情况和融合特征。
我们回顾性分析了2017年7月至2021年6月期间接受OLIF-SA、OLIF-PS或TLIF手术的198例患者（311个节段）。我们评估了患者报告的结局、椎间融合器下沉情况、融合率以及CT扫描的融合特征。
该研究纳入了64例OLIF-SA患者（102个节段）、60例OLIF-PS患者（99个节段）和74例TLIF患者（110个节段）。椎间融合器沉降率分别为33.3%（OLIF-SA）、17.2%（OLIF-PS）和32.8%（TLIF），OLIF-PS与TLIF之间存在显著差异（<0.05）。椎间融合器下沉率无显著差异：11.8%（OLIF-SA）、9.1%（OLIF-PS）和12.7%（TLIF）（>0.05）。融合率分别为100%（OLIF-SA）、97.0%（OLIF-PS）和96.4%（TLIF）（=0.167）。外侧融合率有显著差异：49.0%（OLIF-SA）、30.3%（OLIF-PS）和10.9%（TLIF）（<0.001）。术前骨赘强烈促进外侧融合（<0.001）。术后VAS和ODI评分显著改善（<0.01）。
OLIF-SA、OLIF-PS和TLIF手术均显示出令人满意的结果，融合率相当。值得注意的是，OLIF与TLIF手术在融合特征上存在明显差异，外侧融合在OLIF中更为普遍，尤其是在OLIF-SA手术中。
