Early radiological adjacent segment changes following L4/5 fusion: a retrospective comparative study of oblique lateral interbody fusion and minimally invasive transforaminal lumbar interbody fusion.

Background: Adjacent segment disease (ASD) has become one of the most common complications after lumbar interbody fusion. To date, there have been few reports on the radiological effects between oblique lateral interbody fusion (OLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in lumbar degenerative diseases adjacent to the superior and inferior segments. Method: The data of patients treated with OLIF or MIS-TLIF due to L4/5 degenerative lumbar diseases from October 2018 to March 2022 were retrospectively analyzed. The anterior disc height (ADH), posterior disc height (PDH), intervertebral foramen height (FH), canal anteroposterior diameter (APD), foraminal area (FA), dural sac area (DSA), disc angle (DA), segmental lordosis angle (SLA), and lumbar lordosis (LL) were compared. The incidences of adjacent segment intervertebral disc degeneration (ADD), adjacent articular facet degeneration (AFD), and adjacent segment disease (ASD) were analyzed. Multiple linear regression analysis was performed on DSA of L3/4, L5/S1, and DA of L5/S1. Clinical assessments were performed using the visual analogue scale (VAS) and Oswestry disability index (ODI). Results: At the final follow-up, the Δ SLA, Δ ADH, Δ PDH, Δ FH, Δ FA, and Δ LL of L4/5 in the OLIF group were significantly improved compared with those in the MIS-TLIF group ( Conclusion: Compared with MIS-TLIF, OLIF has advantages in improving lumbar sagittal balance, significantly decreasing degeneration of intervertebral discs and facet joints in adjacent segments in the early stage.