Therapy Potential of Oblique Lumbar Interbody Fusion 360 for Severe Lumbar Spinal Stenosis

Objectives: The advent of O-arm navigation optimized the oblique lumbar interbody fusion (OLIF) procedure, allowing the operator to simultaneously perform OLIF and percutaneous posterior pedicle screw implantation without patient position change, thus improving the fluency and accuracy of the OLIF procedure (called as OLIF360). Nevertheless, a consensus regarding its suitability for patients with severe spinal stenosis remains elusive. This study aims to investigate the clinical efficacy of OLIF360 and its imaging changes in severe lumbar spinal stenosis cases. Methods: This retrospective study analyzed clinical data from 63 patients with severe lumbar spinal stenosis. Fourteen patients were treated with OLIF360, and another 37 patients were treated with posterior lumbar interbody fusion (PLIF). Lumbar spinal stenosis was assessed using the modified Schizas classification. Clinical efficacy scale scores and postoperative imaging parameter changes were compared between the two groups. Shapiro-Wilk, t-tests or Mann-Whitney U tests, repeated measures ANOVA, and Bonferroni post hoc tests were applied for statistical analysis. Results: Both groups showed significant improved pain (p < 0.05). At 1-month and 3-month postoperative follow-ups, OLIF360 group scores superior in Visual Analog Scale than PLIF group (p < 0.05). Greater disc height and lumbar lordosis were displayed in OLIF360 group than PLIF group (p < 0.05). No significant difference in screw placement accuracy between groups was observed. Moreover, significant increases in spinal canal area postoperatively (71.04 +/- 6.27 mm(2) preop to 109.65 +/- 12.34 mm(2) postop, p < 0.05) and bilateral foraminal areas were found in the OLIF360 group. Conclusion: OLIF360 can have promising short-term efficacy for severe lumbar stenosis treatment with shorter recovery time than PLIF.