• World Neurosurg · Nov 2018

    Comparative Study

    Clinical and Radiologic Outcomes of Direct Versus Indirect Decompression with Lumbar Interbody Fusion: A Matched-Pair Comparison Analysis.

    • Guang-Xun Lin, Kutbuddin Akbary, Vit Kotheeranurak, Javier Quillo-Olvera, Hyun-Jin Jo, Xiao-Wei Yang, Akaworn Mahatthanatrakul, and Jin-Sung Kim.
    • Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
    • World Neurosurg. 2018 Nov 1; 119: e898-e909.

    ObjectiveTo compare the radiologic and clinical outcomes between oblique lumbar interbody fusion (OLIF) without laminectomy and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF).MethodsThis was a retrospective study. Between April 2012 and January 2017, 25 patients in each of the MI-TLIF and OLIF groups were recruited as matched pairs. Clinical outcomes included visual analogue scale, Oswestry Disability Index, and satisfaction rates. Radiographic outcomes comprised disc height (DH) and fusion status. Intraoperative data and complications were collected. All patients completed the clinical and radiologic outcomes. Outcomes were compared preoperatively and postoperatively.ResultsMatched pairs were compared between 2 groups in terms of demographic data and preoperative measurements; less blood loss and shorter operative time were found in OLIF versus MI-TLIF (P < 0.001). The total complication rate was 36% in OLIF and 32% in MI-TLIF (P = 0.77). The outcomes of visual analogue scale and Oswestry Disability Index were significantly improved in both groups, and there was no significant difference between 2 groups. Satisfaction rates of the both groups were more than 90%. OLIF was superior to MI-TLIF with respect its capability to restore DH (P < 0.001). Earlier time of fusion was observed in OLIF (80%) compared with MI-TLIF (52%) at 6 months (P = 0.04).ConclusionsOLIF may achieve equivalent clinical and radiologic outcomes compared with MI-TLIF when the stenosis is minimal because the decompression performed is indirect. Furthermore, the OLIF shows less blood loss and shorter operative time, better restoration of DH, and earlier time to fusion than the MI-TLIF.Copyright © 2018 Elsevier Inc. All rights reserved.

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