Comparison Of Short-term Effects Of Oblique Lateral Approach And Interbody Fusion With Transforaminal Lumbar Interbody Fusion For Single-segment Lumbar Degenerative Diseases

Objective: To compare the short-term effects of oblique lumbar interbody fusion(OLIF)and transforaminal lumbar interbody fusion(TLIF)in the treatment of single-segment lumbar degenerative diseases.Method: Retrospective analysis of the clinical data of 33 patients with single-segment lumbar degenerative disease who underwent lumbar spinal decompression by the same group of physicians during the period of 2017.9-2018.9.Patients were divided into two groups according to different surgical procedures: oblique lateral approach interbody fusion(OLIF)group(group 1,14 cases),intervertebral forabody fusion(TLIF)group(group 2,19 cases).The operation time,intraoperative blood loss,postoperative drainage volume,postoperative bed rest time,bone graft fusion rate,posterior margin of intervertebral space and intervertebral foramen height,postoperative complications,postoperative complications,and JOA were compared between the two groups.The low back pain scoring system,the Visua analog scale(VAS),and the Oswestry disability index(ODI)were used to judge the surgical outcome.Result: The operation time: the OLIF group was similar between the TLIF group,and the difference between the two groups was not statistically significant(P>0.05).Intraoperative blood loss: OLIF group was less than TLIF group,the difference between the two groups was not statistically significant(P>0.05).Postoperative drainage: The OLIF group was less than the TLIF group,and the difference between the two groups was statistically significant(P<0.01).Postoperative bed rest time: The OLIF group was shorter than the TLIF group,and the difference was statistically significant(P<0.05).Bone fusion rate: The bone graft fusion rate at 3 months after operation was higher in the OLIF group than in the TLIF group,and the difference between the two groups was not statistically significant(P>0.05).Posterior margin height of the intervertebral space: The patients in the OLIF group increased from 6.78±2.58 mm before surgery to 9.33±2.77 mm,while the patients in the TLIF group increased from 6.80±1.94 mm before surgery to 7.28±1.48 mm.The difference between the two was not statistically significant.Academic significance(P>0.05).Intervertebral foramen height: patients in the OLIF group recovered from preoperative 19.34±3.58 mm to 22.46±3.94 mm at 3 months postoperatively,while patients in the TLIF group recovered from preoperative 19.42±3.04 mm to postoperative 3 months.At 20.07±3.65 mm,the difference between the two groups was not statistically significant(P>0.05).Bone fusion rate: At 3 months postoperatively,the bone graft fusion rate was 100% in the OLIF group and 95% in the TLIF group.There was no significant difference between the two groups(P>0.05).JOA lower back pain scoring system: OLIF group: excellent in 13 cases,good in 1 case,moderate in 0 cases,poor in 0 cases,excellent and good rate was 92.7±6.9%;TLIF group: excellent in 16 cases,good in 3 cases,moderate in 0 cases,There was a difference of 0 cases,the excellent and good rate was 85.3±10%,and the JOA lower back pain scores were significantly lower than those before operation.There was no significant difference between the two groups(P>0.05).ODI score and VAS score: The ODI score and VAS score of the two groups were significantly better than those before surgery at the 3 months follow-up,but the difference between the two groups was not statistically significant(P>0.05).Surgical complications: 2 patients in the OLIF group had pain in the anterior thigh of the affected side.In the TLIF group,1 patient developed postoperative incision infection,and 2 patients developed low back pain after surgery.There were no other serious complications in either group.Conclusion: For single-segment lumbar degenerative lesions,oblique lateral approach interbody fusion can achieve similar clinical symptoms improvement with transforaminal interbody fusion,which can restore intervertebral foramen height and maintain spinal stability.,restore the physiological curvature.At the same time,it has the advantages of high fusion rate,less intraoperative blood loss,and reduced postoperative low back pain.Has a good application prospects.