Spondylolisthesis Reduction and Changes in Sagittal Alignment Following Single-Position Lateral Versus...

Area of Science:

• Spine surgery
• Minimally invasive spine surgery
• Degenerative spine conditions

Background:

• Lateral interbody fusion (LIF) is a minimally invasive technique for degenerative lumbar spondylolisthesis, restoring disc height and correcting alignment.
• Oblique lumbar interbody fusion (OLIF) can be performed in a single lateral position or a dual lateral-then-prone position.
• The impact of patient positioning on OLIF outcomes remains unclear.

Purpose of the Study:

• To compare radiographic outcomes and perioperative complications between single-position lateral OLIF and dual-position lateral-then-prone OLIF.
• To determine the effect of patient positioning on spondylolisthesis correction and spinal alignment.

Main Methods:

• Retrospective cohort study of adult patients undergoing single-level OLIF for degenerative spondylolisthesis.
• Exclusion criteria included revision cases, unrelated procedures, standalone interbody cases, and prone interbody placement.
• Primary outcomes: spondylolisthesis reduction and sagittal alignment changes. Secondary outcomes: operative time, pedicle screw accuracy, and complications.

Main Results:

• 71 patients were analyzed: 29 (40.9%) single-position and 42 (59.1%) dual-position.
• Single-position lateral OLIF cases were 29.4 minutes shorter on average than dual-position cases.
• No significant differences were observed in spondylolisthesis reduction, lordosis, or pedicle screw accuracy between the groups.

Conclusions:

• Single-position lateral OLIF is associated with reduced operative time compared to dual-position OLIF.
• Patient positioning does not significantly affect spondylolisthesis reduction, alignment, or screw accuracy.
• Surgeons can choose either approach based on clinical discretion for cases without complex posterior instrumentation needs.