Comparison of Lateral Interbody Fusion and Posterior Interbody Fusion for Discogenic Low Back Pain

Abstract

AIM: To compare lateral (direct [DLIF] or oblique [OLIF]) and posterior (posterior [PLIF] or transforaminal [TLIF]) lumbar interbody fusion results in patients with the same indication of discogenic low back pain.MATERIAL and METHODS: We enrolled 46 patients who underwent single-level DLIF/OLIF or PLIF/TLIF with at least 1 year of follow-up. Patients were divided into two groups: a lateral group (n=24) who underwent DLIF/OLIF and a posterior group (n=22) who underwent PLIF/TLIF. Clinical, surgical, and radiological outcomes were retrospectively evaluated.RESULTS: Baseline factors, including demographic data, preoperative symptoms, and preoperative radiological findings, were not significantly different between the two groups. In addition, the clinical and radiological outcomes at 1-year post-surgery did not differ between the two groups. However, the DLIF/OLIF procedure conferred significant advantages as follows: favorable postoperative low back pain and patient satisfaction at 1-week and 1-month post-surgery; shorter operation time (mean 173.33 +/- 11.54 versus 208.64 +/- 17.48 min, p<0.001); less blood loss during surgery (mean 127.50 +/- 41.36 versus 372.73 +/- 123.21 mL, p<0.001); and greater restoration of calibrated disc height at 1-year post-surgery (mean 5.80 +/- 1.44 versus 0.50 +/- 1.22, p=0.008). There was no statistically significant difference in the incidence of complications between the two groups. However, complications tended to be more frequent in the lateral group; 7 (29.2%) patients in the lateral group and 3 patients (13.6%) in the posterior group.CONCLUSION: Our findings suggest that the lateral group achieved better perioperative outcomes and disc height restoration than the posterior group, although there was no significant difference in the 1-year clinical outcomes.