Efficacy observation of oblique lateral interbody fusion (OLIF) in treating severe spinal stenosis

OBJECTIVE: This study aimed to evaluate the efficacy and feasibility of oblique lumbar interbody fusion (OLIF) in the treatment of severe lumbar spinal stenosis. METHODS: Retrospectively collected 83 patients diagnosed with severe lumbar spinal stenosis and underwent surgical treatment (OLIF or modified TLIF) in our hospital from January 2022 to June 2024. Routine preoperative X-ray, CT, and MRI examinations were performed. Based on the surgical method, the two groups were divided as follows: Group A: modified transforaminal lumbar interbody fusion (TLIF), Group B: Oblique lumbar interbody fusion (OLIF). Data including age, gender, BMI, preoperative and postoperative VAS scores, ODI scores, differences in spinal canal cross-sectional area (mm²), differences in intervertebral disc height (mm²), and differences in intervertebral foramen area (mm²) were collected from both groups and analyzed. RESULTS: Two groups of patients were compared in terms of age, gender, BMI index, preoperative VAS score, and preoperative ODI index, and no statistically significant differences were found (P > 0.05), indicating comparability. No significant difference was found in the comparison of postoperative VAS scores between the two groups (P > 0.05), suggesting that the efficacy of the two groups was comparable; there were statistically significant differences in operation time and postoperative ODI index (P < 0.05), indicating that Group B had a shorter operation time and better postoperative recovery. There were statistically significant differences in the comparison of the difference in vertebral canal cross-sectional area and the difference in intervertebral foramen area (P < 0.05), suggesting that although the vertebral canal cross-sectional area of Group B was effectively increased, Group B was inferior to Group A in improving vertebral canal cross-sectional area. CONCLUSION: OLIF technique can be used to treat severe lumbar spinal stenosis, and it is safe, minimally invasive, and effective. Although the improvement in the cross-sectional area of the spinal canal and intervertebral foramen in group B was not as significant as in group A, its postoperative functional recovery was better than that of group A. In cases of spinal stenosis with spondylolisthesis, the OLIF technique often results in a more significant expansion of the spinal canal, but attention should be paid to the possibility of the superior articular process tip compressing the exiting nerve root after reduction.