Clinical and Radiographical Efficacy of Single Prone Position Oblique Lateral Interbody Fusion in Lumbar Degenerative Disease

Purpose: Degenerative lumbar diseases like disc degeneration and spinal stenosis significantly impact older adults, leading to pain and reduced mobility. Surgical options like interbody fusion stabilize the spine, with techniques like oblique lateral interbody fusion (OLIF) gaining popularity. Single prone position oblique lateral interbody fusion (prone-OLIF) is a newer variant that eliminates patient repositioning and aims to improve outcomes compared to minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). This study compares the clinical and radiographic results of prone-OLIF and MIS-TLIF. Method: This retrospective study involved 28 prone-OLIF patients and 56 MIS-TLIF patients, matched 1:2 based on age, comorbidity index, and fused spinal levels. Anthropometric, clinical, and radiographic outcomes were compared using statistical analyses. Results: Prone-OLIF showed superior postoperative clinical outcomes with lower Oswestry disability index (ODI) scores at 5.61 and visual analogue scores (VAS) at 1.43, compared to 11.00 and 3.64 in the MIS-TLIF group, respectively. It also resulted in greater sagittal alignment correction, with a 5.46° improvement in the regional lumbar lordotic angle versus 0.19° in MIS-TLIF. Additionally, prone-OLIF had less intraoperative blood loss but longer operation times. Conclusion: Prone-OLIF offers superior clinical and radiographic outcomes over MIS-TLIF in pain relief, functional improvement, and spinal alignment correction, despite longer surgical times. Further studies with larger cohorts are needed to validate these findings.