Effect of Approach Based Lumbar Interbody Fusion on Sagittal Spinopelvic Parameters and Functional Outcomes: Comparison between Oblique Lumbar Interbody Fusion (OLIF) and Transforaminal Lumbar Interbody Fusion (TLIF).

IF 1.1 4区 医学 Q3 ORTHOPEDICS Indian Journal of Orthopaedics Pub Date : 2024-10-03 eCollection Date: 2025-01-01 DOI:10.1007/s43465-024-01229-w
Mantu Jain, Siddharth S Sethy, Auroshish Sahoo, Shahnawaz Khan, Sujit Tripathy, Mathan Kumar Ramasubbu
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Abstract

Purpose: Transforaminal lumbar interbody fusion (TLIF) and oblique lumbar interbody fusion (OLIF) are the most commonly conducted operations for interbody fusions. In addition to fusion, the restoration of proper spinal alignment has become crucial for achieving favorable functional outcomes. There is a lack of agreement on which lumbar interbody fusion technique provides the most effective correction for sagittal spinopelvic parameters (SSPs). This study aims to investigate the functional outcome in terms of SSPs in patients undergoing single level OLIF and TLIF for lumbar degenerative disc disease.

Methodology: Retrospective analysis of single level OLIF or TLIF was done. The patients' index and follow-up data until 6 months of surgery were collected. Radiographic parameters analysis included disc height (DH), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), pelvic index, lumbar lordosis (LL), segmental lordosis (SL). Clinical outcomes were recorded using visual analogue scale (VAS) and Oswestry Disability Index (ODI).

Results: In a total of 38 patients (19 in each group) mean age was 51.52 ± 12.67 years in OLIF and 52.17 ± 9.73 years in TLIF. Improvement in DH was more in OLIF but not statistically significant (p = 0.075). Significant improvements were seen in PT, and SL post-TLIF. Change in SSPs among groups shown no significant differences. Both VAS and ODI shown improvements in both the groups but no significant difference was noted while comparing the two groups.

Conclusion: The study showed better restoration of SSPs by TLIF in terms of PT and SL although functional outcomes appear similar in both procedures. Increase in DH is the important determinant for resulting good outcome. Patients with maintained spinopelvic balance can be treated satisfactorily with less-invasive OLIF.

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基于入路的腰椎椎间融合术对矢状椎盂参数和功能结果的影响:斜腰椎椎间融合术(OLIF)和经椎间孔腰椎椎间融合术(TLIF)的比较
目的:经椎间孔腰椎椎间融合术(TLIF)和斜腰椎椎间融合术(OLIF)是最常用的椎间融合术。除了融合外,恢复脊柱的正确对齐对于获得良好的功能预后也至关重要。对于哪种腰椎椎体间融合技术能够最有效地矫正矢状椎盂参数(ssp),目前还缺乏共识。本研究旨在探讨单水平OLIF和TLIF治疗腰椎间盘退行性疾病患者ssp的功能结果。方法:回顾性分析单水平OLIF或TLIF。收集患者指标及术后6个月的随访资料。影像学参数分析包括椎间盘高度(DH)、骨盆发生率(PI)、骨盆倾斜(PT)、骶骨斜度(SS)、骨盆指数、腰椎前凸(LL)、节段性前凸(SL)。采用视觉模拟量表(VAS)和Oswestry残疾指数(ODI)记录临床结果。结果:38例患者(每组19例),OLIF组平均年龄51.52±12.67岁,TLIF组平均年龄52.17±9.73岁。OLIF患者的DH改善更明显,但无统计学意义(p = 0.075)。tlif后PT和SL均有显著改善。各组间ssp变化无显著性差异。两组VAS和ODI均有改善,但两组比较无显著差异。结论:研究显示TLIF在PT和SL方面可以更好地恢复ssp,尽管两种方法的功能结果相似。DH的增加是产生良好结果的重要决定因素。保持脊柱骨盆平衡的患者可以用微创OLIF治疗。
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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
185
审稿时长
9 months
期刊介绍: IJO welcomes articles that contribute to Orthopaedic knowledge from India and overseas. We publish articles dealing with clinical orthopaedics and basic research in orthopaedic surgery. Articles are accepted only for exclusive publication in the Indian Journal of Orthopaedics. Previously published articles, articles which are in peer-reviewed electronic publications in other journals, are not accepted by the Journal. Published articles and illustrations become the property of the Journal. The copyright remains with the journal. Studies must be carried out in accordance with World Medical Association Declaration of Helsinki.
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