Midline Lumbar Fusion Versus Posterior Lumbar Interbody Fusion Involving L5-S1 For Degenerative Lumbar Diseases: A Comparative Study

BACKGROUND: A retrospective cohort study to evaluate the efficacy and safety of midline lumbar fusion (MIDLF) for lumbosacral fusion compared to posterior lumbar interbody fusion (PLIF).METHODS: Patients who had undergone posterior lumbosacral fusion surgery were divided into a MIDLF group (n = 37) and a PLIF group (n = 42). The follow-up time was at least 12 months. The operation data, recov-ery condition, complications, clinical outcomes, and status of implants and fusion were compared between the 2 groups.RESULTS: The MIDLF group experienced significantly less blood loss, lower postoperative creatine kinase levels and total drainage volume, earlier time to ambu-lation, and less hospital stay times after surgery compared to the PLIF group (P< 0.05). The mean postoperative back pain visual analog scale scores in the MIDLF group were significantly lower than the PLIF group (P < 0.05). The improvement in Oswestry Disability Index scores during 3-month follow-up displayed a significant difference be-tween the 2 groups (P < 0.05). The fusion rate tended to be higher in the MIDLF group; however, the difference was not significant (P > 0.05). There was no significant dif-ference in respect to screw loosening and cage subsi-dence rate. There were 2 cases of complications both occurring in the PLIF group.CONCLUSIONS: MIDLF is safe and effective for lumbo-sacral fusion and in line with the concept of enhanced recovery after surgery.