Abstract:

Objective The aim of this study was to compare the clinical effects of oblique lumbar inter⁃ body fusion（OLIF）combined with lateral plate fixation（OLIF ⁃ LP）or posterior bilateral pedicle screw fixation （OLIF⁃BPS）in the treatment of single⁃segment lumbar degenerative diseases（LDD）. Methods A total of 64 patients with single ⁃ segment LDD who received lumbar decompression and fusion surgery in our hospital from May 2020 to March 2021 were selected. The patients were divided into OLIF⁃LP group（28 cases）and OLIF⁃BPS （36 cases）according to the surgical methods. The operation time，intraoperative bleeding volume，creatine kinase （CK），average hospitalization days and complications of patients in both groups were recorded. VAS for lumbar and leg pain and ODI scores were used to compare the clinical efficacy of the two groups. Disk height（DH），Cross⁃ sectional area（CSA）and lumbar lordosis（LL）were measured at different time points by imaging，and the inter⁃ body fusion was evaluated. Results The operation time（79.61 ± 14.11）min，the intraoperative bleeding volume （64.86 ± 15.01）mL in OLIF⁃LP group were less than those in OLIF⁃BPS group（108.61 ± 20.69）min，（99.58 ± 22.28）mL. The CK at 1 and 7 days postoperation were significantly lower in OLIF⁃LP group than those in OLIF⁃ BPS group（P < 0.05）. The VAS score and ODI of low back pain in both groups were significantly lower than thosepreoperation. The VAS score of low back pain in OLIF ⁃ LP group was significantly lower than that in OLIF ⁃BPS group at 7 days postoperation（P = 0.04），but there was no significant difference between the two groups at the last follow⁃up（P = 0.43）. DH，LL and CSA at each time point postoperation were significantly improved as compared with those preoperation（P < 0.001），there was no significant difference between the two groups（P > 0.05）. At half a year postoperation，the fusion rate was comparable（89.29% vs. 91.67%，P = 0.75）. Complications occurred in 5 cases（17.86%）and 7 cases（19.44%）in OLIF⁃LP group and OLIF⁃BPS group respectively，and the incidence was not statistically significant（P = 0.87）. According to the subsidence criteria，the subsidence rate of OLIF⁃LP group was 21.43%（6/28），and that of OLIF⁃BPS group was 19.44%（7/36）. Without symptom in all subsidence cases. Conclusions Under the premise of strictly grasping the surgical indications，OLIF ⁃LP technique could obtain comparable effective outcomes as OLIF⁃BPS surgery for the treatment of LDD，and patients with OLIF⁃LP have less trauma，less pain after surgery.

Key words:

oblique lumbar interbody fusion, minimally invasive, lateral plate fixation, pedicle screw fixation