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Updated: Sep 6, 2026
Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability
Published on: July 25, 2025
One-Level or Multilevel Interbody Fusion for Multilevel Lumbar Degenerative Diseases: A Prospective Randomized
Tiefeng Li1, Lei Shi1, Yibin Luo1
1Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Background:
The treatment of multilevel lumbar degenerative disease (LDD) is complicated and challenging, and the optimal surgical strategy remains controversial.
Objective:
To compare the differences in clinical and radiologic outcomes and in complications after 1-level interbody fusion versus multilevel interbody fusion for the treatment of multilevel LDD.
Methods:
A total of 100 patients with multilevel LDD were randomized in a 1:1 ratio into the 1-level interbody fusion group or the multilevel interbody fusion group. Clinical and radiologic results and major complications in the 2 groups were analyzed. Clinical outcomes were assessed using the Visual Analog Scale for radicular and back pain, the Oswestry Disability Index, and the short-form 36 physical score. Clinical status was assessed by the Whitecloud classification. Radiologic evaluation included assessment of lumbar lordosis, pelvic incidence, and sacral slope.
Results:
There were no significant differences in clinical and radiologic results between the 2 groups. Procedure duration and intraoperative blood loss were significantly greater in the multilevel interbody fusion group than in the 1-level interbody fusion group; the multilevel interbody fusion group also had greater incidences of temporary nerve root palsy, wound infection, and adjacent segment disease.
Conclusion:
A hybrid technique including 1-level interbody fusion and multilevel posterolateral fusion is recommended for patients with multilevel LDD.
