Lumbar interbody fusion using oblique (OLIF) and lateral (LLIF) approaches for degenerative spine disorders: a meta-analysis of the comparative studies

• Published in: European journal of orthopaedic surgery & traumatology Vol. 33; no. 1; pp. 1 - 7
• Main Authors: Ricciardi, Luca, Piazza, Amedeo, Capobianco, Mattia, Della Pepa, Giuseppe Maria, Miscusi, Massimo, Raco, Antonino, Scerrati, Alba, Somma, Teresa, Lofrese, Giorgio, Sturiale, Carmelo Lucio
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.01.2023; Springer Nature B.V
• Subjects: Back pain; Back surgery; Blood Loss, Surgical; Cerebrospinal fluid; Degenerative disc disease; General Review; Humans; Libraries; Lumbar Vertebrae - surgery; Medical databases; Medicine; Medicine & Public Health; Meta-analysis; Neurosurgery; Orthopedics; Retrospective Studies; Spinal Diseases - surgery; Spinal Fusion - adverse effects; Surgeons; Surgical Orthopedics; Surgical outcomes; Systematic review; Traumatic Surgery; Treatment Outcome; Spondylolisthesis; Low-back pain; Degenerative disk disease; Lumbar; Fusion
• ISSN: 1432-1068; 1633-8065; 1432-1068
• DOI: 10.1007/s00590-021-03172-0

Study design Systematic review and meta-analysis . Objective Historically, posterior approaches to the lumbar spine have allowed surgeons to manage degenerative conditions affecting the lumbar spine. However, spinal muscles injury, post-surgical vertebral instability, cerebrospinal fluid (CSF) leakage, and failed back surgery syndrome (FBSS) represent severe complications that may occur after these surgeries. Lumbar interbody fusion using anterior (ALIF), oblique (OLIF), or lateral (LLIF) approaches may represent valuable surgical alternatives, in case fusion is indicated on single or multiple levels. Methods The present study is a systematic review, conducted according to the PRISMA statement, of comparative studies on OLIF, and LLIF for degenerative spine disorders, and a meta-analysis of their clinical-radiological outcomes and complications. Results After screening 1472 papers on PubMed, Scopus, and Cochrane Library, only 3 papers were included in the present study. 318 patients were included for data meta-analysis, 128 in OLIF group, and 190 in LLIF group. There were no significative differences in terms of surgical (intraoperative blood loss and surgical duration) and clinical (VAS-back, VAS-leg, and ODI scores) outcomes, or fusion rates at last follow-up (> 2 years). Significantly higher rates of abdominal complications, system failure, and vascular injuries were recorded in the OLIF group. Conversely, postoperative neurological symptoms and psoas weakness were significatively more common in LLIF group. Conclusions The meta-analysis suggests that OLIF and LLIF are both effective for lumbar degenerative disorders, although each of them presents specific complications and this should represent a relevant element in the surgical planning.