Comparison Of The Clinical Application And Early Curative Effect Between Oblique And Posterior Lumbar Interbody Fusion In The Treatment Of Degenerative Lumbar Scoliosis

ObjectiveTo evaluate the clinical application and early curative effect between oblique lumbar interbody fusion and posterior lumbar interbody fusion in patients with degenerative lumbar scoliosis.MethodsThis study retrospectively analyzed the case data of 40 patients with degenerative lumbar scoliosis in our hospital from October 2016 to September 2018.Among which,19 cases underwent oblique lumbar Interbody fusion(OLIF group)and 21 cases underwent posterior lumbar interbody fusion(PLIF group).The operation time,intraoperative blood loss,incision length,stay bed and hospital stay were recorded.The clinical effects were evaluated using Visual Analog Scale(VAS)and the Oswestry Disability Index(ODI).The radiographic parameters were evaluated using the lumbar scoliosis Cobb angle,sagittal vertical axis(SVA),coronal vertical axis(CVA),lumbar lordosis(LL),pelvic tilt(PT),sacral slope(SS),the height of intervertebral space(DH).ResultsThe average follow-up time of OLIF group was(21.68 ± 5.70)months and the PLIF group was(26.52 ± 5.85)months.The operation time,intraoperative blood loss,incision length and the hospital stay of the OLIF group were shorter than the PLIF group(P<0.05).The VAS scores for back pain and the ODI of the two groups were significantly decreased,which compared with the preoperative(P<0.05),but all of them in OLIF group was significantly more decreased than in PLIF(P<0.05)at 7 days and 3months postoperatively,but at the last follow-up there were no significant difference between the two groups(P>0.05).The lumbar scoliosis Cobb angle,sagittal vertical axis(SVA),coronal vertical axis(CVA),pelvic tilt(PT),lumbar lordosis(LL),sacral slope(SS)and the height of intervertebral space(DH)were significantly improved postoperatively(P<0.05)in the two groups.But the OLIF group showed higher DH,smaller Cobb angle,and greater LL than the PLIF group at any time point(P<0.05).But there were no significant difference in SVA,CVA,PT and SS between the two groups at any follow-up points(P>0.05).The overall complication rate was slightly higher in the PLIF group(47.62%)than in the OLIF group(26.32%)without significant difference(x2=1.931,P=0.165).But the incidence of major complications in the PLIF group was significantly higher than that in the OLIF group(Fisher,P=0.026).Conclusion1.The patients in both groups achieved satisfactory results.Which compared with the PLIF,the OLIF group showed higher DH,smaller Cobb angle,and greater LL than the PLIF group.2.OLIF tchnology has the characteristic of small incision,quick recovery,and fewer complications related to the surgical approach.The early efficacy is worthy of recognition,but long-term efficacy requires further follow-up.