Massimo Miscusi, Alessandro Ramieri, Stefano Forcato, Mary Giuffrè, Sokol Trungu, Marco Cimatti, Alessandro Pesce, Pietro Familiari, Amedeo Piazza, Cristina Carnevali, Giuseppe Costanzo, Antonino Raco


June 2018, Volume 27, Issue 2, pp 222 - 228 Original Article Read Full Article 10.1007/s00586-018-5596-y

First Online: 18 April 2018

Purpose

The most effective interbody fusion technique for degenerative disk disease (DDD) is still controversial. The purpose of our study is to compare pure lateral (LLIF) and oblique lateral (OLIF) approaches for the treatment of lumbar DDD from L1–L2 to L4–L5, in terms of clinical and radiological outcomes.

Materials and methods

45 patients underwent lumbar interbody fusion for pure lumbar DDD from  L1–L2 to L4–L5 through LLIF (n = 31, mean age 62.1 years, range 45–78 years) or OLIF (n = 14, mean age 57.4 years, range 47–77 years). Clinical evaluations were performed with ODI and SF-36 tests. Radiological assessment was based on the modification of coronal segmental Cobb angles and segmental lumbar lordosis (L1–S1).

Results

On ODI and SF-36, all patients presented good results at follow-up, with 26% the difference between the LIF and OLIF groups on ODI scale in the post-operative period, and 3.9 and 8.8 points difference on physical and mental SF-36 in favor of OLIF. Radiological parameters improved significantly in both groups. The mean correction was 6.25° for cCobb (11.3° in LIF and 1.9° in OLIF), 2.5° for sLL (2° in LLIF and 4° in OLIF).

Conclusions

LLIF and OLIF represent safe and effective MIS procedures for the treatment of lumbar DDD. LLIF had some risks of motor deficit and monitoring is mandatory, though it addressed more the coronal deformities. OLIF did not imply risks for motor deficits, but attention should be paid to vascular anatomy. It was more effective in kyphotic segmental deformities.

Graphical abstract

These slides can be retrieved under Electronic Supplementary material. [Figure not available: see fulltext.]


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