Oblique lumbar interbody fusion with unilateral pedicle screw fixation in a single lateral position for degenerative lumbar diseases.

OBJECTIVE

This study aimed to evaluate the clinical efficacy of oblique lumbar interbody fusion (OLIF) combined with unilateral pedicle screw fixation (OLIF-UPS) performed in a single lateral position for degenerative lumbar diseases.

METHODS

Clinical data of patients who underwent OLIF-UPS in a single lateral position were collected retrospectively. During the same period, patients who received OLIF combined with bilateral pedicle screw fixation (OLIF-BPS) requiring intraoperative position change were enrolled as the control group. Perioperative parameters, Visual Analogue Scale (VAS) scores, Oswestry Disability Index (ODI) scores, and the modified MacNab criteria were recorded to assess clinical outcomes. Radiographic parameters, including disc height (DH), lumbar lordosis (LL), cage subsidence rate, and interbody fusion rate, were compared between the two groups.

RESULTS

The operative time in the OLIF-UPS group was significantly shorter than that in the OLIF-BPS group (p <0.001), whereas no significant differences were observed in intraoperative blood loss or postoperative hospital stay between the two groups (p >0.05). Postoperatively, VAS scores for back and leg pain and ODI scores were significantly improved in both groups compared with preoperative values (p <0.001), with a further improvement noted at 1 year postoperatively compared with 1 month postoperatively. Postoperative DH and LL were significantly increased in both groups relative to preoperative measurements (p <0.001). A slight reduction in DH and LL was observed at 1 year postoperatively compared with the immediate postoperative period, but this difference was not statistically significant (p >0.05). The interbody fusion rate was 92.2% in the OLIF-UPS group and 93.5% in the OLIF-BPS group. Both groups achieved favorable functional recovery and high patient satisfaction.

CONCLUSION

In patients with normal to near-normal bone density (T-score > -2.5), Grade I or no spondylolisthesis, no segmental instability, and BMI <30 kg/m2, single-position OLIF-UPS achieves short-term outcomes comparable to OLIF-BPS while significantly reducing operative time. Given the relatively short follow-up period, further long-term observation is warranted to verify its long-term clinical efficacy.