Oblique lateral interbody fusion versus transforaminal lumbar interbody fusion for single-level lumbar adjacent segment disease: a retrospective comparative study of clinical and radiographic outcomes.

OBJECTIVE

To compare the clinical and radiographic outcomes of oblique lateral lumbar interbody fusion (OLIF) versus transforaminal lumbar interbody fusion (TLIF) for single-level lumbar adjacent segment disease (ASDis).

METHODS

A retrospective study was conducted on 107 patients who underwent revision surgery for single-level ASDis. Patients were divided into OLIF group (n = 55) and TLIF group (n = 52). Perioperative parameters (operative time, blood loss), clinical outcomes (VAS for low back and leg pain, Oswestry Disability Index, EQ-5D), radiographic parameters (disc height, segmental lordosis, segmental coronal angle, lumbar lordosis, PI-LL), complication and fusion rates were compared. Follow-up was ≥12 months.

RESULTS

OLIF had significantly longer operative time (308.5 ± 62.7 vs. 271.3 ± 55.9 min, P = 0.002) but less blood loss (362.4 ± 51.3 vs. 608.7 ± 76.5 mL, P < 0.001). No significant differences were found between groups in VAS, ODI, EQ-5D scores at any time point (P > 0.05). OLIF demonstrated superior correction of disc height ( Δ 3.9 ± 1.4 vs. 2.2 ± 0.8 mm, P < 0.001), segmental lordosis ( Δ 3.8°±1.7° vs. 2.3°±1.8°, P < 0.001), and segmental coronal angle ( Δ 1.6°±0.6° vs. 1.2°±0.5°, P < 0.001). No significant differences were observed in lumbar lordosis, PI-LL correction, complication rates (10.91% vs. 9.62%, P = 0.826), cage subsidence (12.73% vs. 11.54%, P = 0.850), reoperation rates (3.64% vs. 1.92%, P = 0.618), or fusion rates (92.73% vs. 92.31%, P = 0.934).

CONCLUSION

OLIF and TLIF provide equivalent clinical outcomes for single-level lumbar ASDis. OLIF offers advantages in reducing intraoperative blood loss and restoring segmental radiographic parameters, at the cost of longer operative time. TLIF is associated with shorter surgery. Both techniques have comparable complication and fusion rates. Surgical choice should be individualized.