• Pengchao Yang, Yimin Dong, Yong Xu, Honglei Kang, Feng Li, and Hanfeng Guan.
• Department of orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
• World Neurosurg. 2024 Oct 1; 190: e841e850e841-e850.

ObjectiveTo investigate the improvement of spinopelvic parameters and therapeutic efficacy in the treatment of complex degenerative lumbar spondylolisthesis (CDLS) after oblique lumbar interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF).MethodsFrom January 2018 to December 2020, 71 patients with CDLS underwent OLIF or TLIF at the same hospital: 31 in the OLIF group and 40 in the TLIF group. The spinopelvic parameters, perioperative data, and clinical outcomes were elected and compared between the 2 groups.ResultsThere were no statistic differences in demographic perioperative complication rates and preoperative spinopelvic parameters between the two groups. OLIF group showed lower serum C-reactive protein in the early postoperative stage, shorter length of stay, less estimated blood loss and larger slippage correction rate (88.05 vs. 62.37%) (all P ＜ 0.05). There was no significant difference in the visual analog scale and Oswestry disability index scores before operation and three and six months after surgery, but OLIF group was better in the long-term with visual analog scale and Oswestry disability index (1.7/13.2 vs. 2.3/16.5). And it was significantly different in the lumbar lordosis angle, segmental lordosis angle, pelvic tilt, sacral slope (46.0°/9.3°/18.2°/35.9° vs. 40.4°/7.2°/23.9°/31.1°), and sagittal vertical axis (21.6 vs. 31.7mm) after surgery between OLIF and TLIF groups (all P ＜ 0.05).ConclusionsIn the therapy of CDLS, OLIF can better reduce pelvic tilt, L1 axis S1 distance, and sagittal vertical axis, and increase lumbar lordosis angle and sacral slope, showing advantages over TLIF in improving and maintaining spinopelvic parameters. Although there was no difference in complication rates between OLIF and TLIF, OLIF was more minimally invasive, had less tissue damage, had faster recovery, and had better long-term outcomes.Copyright © 2024 Elsevier Inc. All rights reserved.

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