A comparative study of O-arm navigation-assisted OLIF 360 versus traditional OLIF combined with Mazor Renaissance robot-assisted posterior fixation for single-level lumbar spondylolisthesis: clinical and radiographic outcomes.

PURPOSE: This study aimed to compare the perioperative efficiency, clinical outcomes, and radiographic outcomes of single-position O-arm navigation-assisted oblique lumbar interbody fusion (OLIF) 360 with those of dual-position traditional OLIF combined with Mazor Renaissance robot-assisted posterior fixation in patients with single-level lumbar spondylolisthesis.

METHODS

This retrospective study included 110 patients with single-level L4-L5 lumbar spondylolisthesis who underwent surgery between March 2022 and January 2025. Of these, 50 patients underwent traditional OLIF combined with robot-assisted posterior fixation, and 60 underwent O-arm navigation-assisted OLIF 360. The severity of spondylolisthesis was classified according to the Meyerding grading system. Baseline characteristics; intraoperative parameters, including operative time, estimated blood loss, and radiation dose; postoperative outcomes, including length of hospital stay, clinical scores, and radiographic changes; and fusion rates and complications were compared between the two groups.

RESULTS

All patients completed 12 months of postoperative follow-up. Both groups showed significant improvements in Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores compared with preoperative values (p < 0.05). No significant differences in VAS or ODI scores were observed between the groups at the 3- or 12-month follow-up. Compared with the robot-assisted group, the navigation-assisted group had a significantly shorter operative time, lower intraoperative blood loss, and lower total intraoperative radiation dose (p < 0.05). No significant intergroup differences were observed in the improvement rates of spinal canal area (SCA) or disc height (DH), changes in lumbar lordosis (LL), screw placement accuracy, or BSF-defined radiographic fusion rates.

CONCLUSION

O-arm navigation-assisted OLIF 360 was associated with improved perioperative efficiency, including shorter operative time, reduced intraoperative blood loss, and lower radiation exposure, while achieving clinical and radiographic outcomes comparable to those of traditional OLIF combined with robot-assisted posterior fixation. Screw placement accuracy and BSF-defined radiographic fusion rates were also similar between the two techniques.