Clinical and Radiologic Comparisons Between Oblique Lumbar Interbody Fusion Combined with Percutaneous Pedicle Screw Fixation and Transforaminal Lumbar Interbody Fusion for Adult Isthmic Spondylolisthesis: A 2-year Follow-Up Study.

Background: Adult isthmic spondylolisthesis (AIS) results in the anterior translation of the vertebral body with neural encroachment. Although oblique lumbar interbody fusion (OLIF) is minimally invasive technique that uses a retroperitoneal plane to achieve indirect decompression compared to transforaminal lumbar interbody fusion (TLIF), research on OLIF for AIS remains limited. Therefore, we aimed to compare the clinical and radiologic outcomes of these 2 surgical techniques for AIS.
Methods: We analyzed the details of 62 patients with AIS who were treated with either OLIF (n = 26) or TLIF (n = 36) between 2019 and 2022, with a minimum 2-year follow-up. The 2 surgical techniques were compared in terms of perioperative surgical, radiologic, and clinical outcomes. The correlation between the severity of foraminal stenosis and clinical outcomes was evaluated.
Results: The OLIF group experienced significantly less blood loss, shorter operative times, and shorter hospital stay than the TLIF group. Radiologic assessments showed no significant preoperative differences in disc height or slippage ratios, but postoperative slippage correction was significantly greater in the OLIF group than in the TLIF group (13.5 ± 8.0 vs. 5.0 ± 8.9; P < 0.001). The clinical outcome improvement ratios did not differ significantly between the 2 groups. The correlation between preoperative severity of foraminal stenosis and clinical outcomes in the OLIF group was not significant.
Conclusions: OLIF is more advantageous than TLIF in terms of blood loss, operative time, hospital stay, and anterolisthesis correction. In addition, good clinical outcomes were obtained with indirect decompression alone, regardless of the severity of foraminal stenosis. Therefore, OLIF is a good surgical option for the treatment of AIS.
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