Comparative effectiveness of oblique lumbar interbody fusion with anterior screw fixation versus percutaneous pedicle screw fixation for treating lumbar degenerative diseases: A systematic review and meta-analysis

Abstract

Purpose Lumbar degenerative diseases impose a substantial health burden, prompting the exploration of advanced surgical approaches such as Oblique Lumbar Interbody Fusion (OLIF). This meta-analysis aims to evaluate the comparative efficacy of OLIF with anterior screw fixation (OLIF-AF) against OLIF with posterior pedicle fixation (OLIF-PF) in addressing these conditions. Methods A systematic search across multiple databases identified five studies meeting inclusion criteria, incorporating a total of 271 patients. Comparative analysis encompasses primary and secondary outcomes related to fusion rates, intraoperative parameters, patient-reported measures, and radiographic assessments. Results Primary outcome analysis demonstrated no statistically significant difference in total fusion rates between OLIF-AF and OLIF-PF. However, secondary outcomes revealed distinct advantages in OLIF-AF, showcasing lower intraoperative blood loss and reduced operative times compared to OLIF-PF. Nonetheless, patient-reported outcomes, encompassing measures such as pain scores and functional assessments, as well as radiographic parameters, exhibited no significant variations between the two techniques. Conclusion While OLIF-AF displayed favorable results in intraoperative parameters, such as reduced blood loss and shorter operative times, it did not significantly differ in patient-reported outcomes and radiographic assessments compared to OLIF-PF. Interpretation of findings must consider limitations in sample sizes and study heterogeneity. Future investigations with larger, more diverse cohorts and extended follow-ups are imperative to confirm these preliminary findings and comprehend the actual clinical impact of these OLIF techniques in managing lumbar degenerative diseas.