Meta-analysis of the efficacy and safety of OLIF and TLIF in the treatment of degenerative lumbar spondylolisthesis

Microscopic and Biomechanical Analysis of PEEK Interspinous Spacers for Spinal Fusion Applications

Spinal fusion is a surgical intervention used to join two or more vertebrae in the spine. An often-used method involves the placement of intervertebral spacers. They are commonly composed of biocompatible materials like polyetheretherketone. It has strength, longevity, and the capacity to interact harmoniously with the human body. Standardized mechanical tests were performed on two distinct implants to assess their biomechanical characteristics. The studies were conducted at a velocity of 2 mm/min. The stopping criteria were determined based on the loads sustained by the 50th percentile. Furthermore, the chemical composition of the implants was assessed using Raman spectroscopy. The implant created via subtractive manufacturing has a significant change in its elastic region at a force of 1300 N, and it begins subsidence when vertebrae are subjected to a load of 1500 N. The integration of microscopic characterization techniques with the mechanical analysis of prostheses in numerous case studies facilitates the biomechanical evaluation of implants.

Effect of Approach Based Lumbar Interbody Fusion on Sagittal Spinopelvic Parameters and Functional Outcomes: Comparison between Oblique Lumbar Interbody Fusion (OLIF) and Transforaminal Lumbar Interbody Fusion (TLIF)

PURPOSE

Transforaminal lumbar interbody fusion (TLIF) and oblique lumbar interbody fusion (OLIF) are the most commonly conducted operations for interbody fusions. In addition to fusion, the restoration of proper spinal alignment has become crucial for achieving favorable functional outcomes. There is a lack of agreement on which lumbar interbody fusion technique provides the most effective correction for sagittal spinopelvic parameters (SSPs). This study aims to investigate the functional outcome in terms of SSPs in patients undergoing single level OLIF and TLIF for lumbar degenerative disc disease.

METHODOLOGY

Retrospective analysis of single level OLIF or TLIF was done. The patients' index and follow-up data until 6 months of surgery were collected. Radiographic parameters analysis included disc height (DH), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), pelvic index, lumbar lordosis (LL), segmental lordosis (SL). Clinical outcomes were recorded using visual analogue scale (VAS) and Oswestry Disability Index (ODI).

RESULTS

In a total of 38 patients (19 in each group) mean age was 51.52 ± 12.67 years in OLIF and 52.17 ± 9.73 years in TLIF. Improvement in DH was more in OLIF but not statistically significant (p = 0.075). Significant improvements were seen in PT, and SL post-TLIF. Change in SSPs among groups shown no significant differences. Both VAS and ODI shown improvements in both the groups but no significant difference was noted while comparing the two groups.

CONCLUSION

The study showed better restoration of SSPs by TLIF in terms of PT and SL although functional outcomes appear similar in both procedures. Increase in DH is the important determinant for resulting good outcome. Patients with maintained spinopelvic balance can be treated satisfactorily with less-invasive OLIF.

Risk factors analysis and predictive model of degree I degenerative lumbar spondylolisthesis

STUDY DESIGN

Retrospective Case-Control Study.

BACKGROUND

There have been some previous studies on the risk factors associated with lumbar spondylolisthesis, but there are few studies on the risk factors for disease progression in mild degenerative lumbar spondylolisthesis (DLS). To analyze the risk factors associated with aggravation of spondylolisthesis in patients with grade I degenerative spondylolisthesis and construct a prediction model.

METHODS

We conducted a retrospective analysis of 220 patients diagnosed with DLS who were admitted to our hospital between January 2019 and January 2023. Data collected included gender, age, body mass index (BMI), diabetes, hypertension, occupation, and imaging parameters.

RESULTS

A total of 220 patients were included in this study, including 111 males and 109 females; 178 patients with no aggravation of lumbar spondylolisthesis (group A) and 42 patients with aggravation of lumbar spondylolisthesis (group B). Progression of grade I DLS was associated with single factors such as age, BMI, Occupation, vertebral CT value, facet joint angle (FJA), Modic change (MC), Pfirrmann grade of intervertebral disc (PG), Facet joint effusion (FJE), osteophyte formation, and Percentage of the Fat Infiltration (FIA%) of multifidus muscle (MM). BMI, FJA, PG, and FI% of MM had a significant impact on disease progression in lumbar spondylolisthesis.

CONCLUSION

BMI, FJA, PG, and FIA% of MM were independent risk factors for the progression of degenerative spondylolisthesis. The risk prediction model was established by including the above four variables and nomograms were drawn. The internal validation proved that the model had good discrimination, calibration, and clinical practicability.

Comparative analysis of the efficacy of oblique lateral interbody fusion versus transforaminal lumbar interbody fusion in the treatment of lumbar disc herniation

Lumbar disc herniation (LDH) often necessitates surgical intervention when conservative treatments fail. Oblique Lateral Interbody Fusion (OLIF) and Transforaminal Lumbar Interbody Fusion (TLIF) are two commonly used techniques for treating LDH, each offering distinct surgical approaches. This study aimed to compare the efficacy of OLIF versus TLIF in terms of pain relief, functional outcomes, spinal alignment correction, fusion success, and postoperative recovery. A retrospective study was conducted on 133 patients who underwent either OLIF (n = 68) or TLIF (n = 65) between January 2020 and December 2022. Data on patient demographics, pain and functional outcomes (measured by Visual Analogue Scale [VAS] and Oswestry Disability Index [ODI]), radiological outcomes (sagittal and coronal Cobb angles, apical vertebra deviation), fusion and collapse rates, and postoperative recovery (ambulation time and hospitalization duration) were collected. Statistical analysis was performed using t-tests and chi-square tests, with significance set at P < 0.05. Both groups demonstrated significant postoperative improvements in pain and functional outcomes. OLIF resulted in significantly better long-term pain reduction (VAS 1.99 ± 0.67 vs. 2.29 ± 0.92, P = 0.03) and greater spinal alignment correction, particularly in sagittal Cobb angle and apical vertebra deviation (P < 0.001). The fusion rate was similar between OLIF (97.92%) and TLIF (96.61%, P = 0.56), but OLIF had a lower collapse rate (8.33% vs. 18.64%, P < 0.001). OLIF also facilitated faster postoperative recovery, with earlier ambulation and shorter hospitalization time (P < 0.001 for both). While both OLIF and TLIF are effective for treating LDH, OLIF offers superior long-term pain relief, better spinal alignment correction, reduced collapse rates, and faster recovery. These findings suggest that OLIF may be a more advantageous option for patients requiring lumbar interbody fusion.