Clinical value and effectiveness profiles of oblique lateral interbody fusion and posterior lumbar interbody fusion in the treatment of lumbar brucellosis spondylitis

OBJECTIVE: The aim of this study was to assess the clinical efficacy of oblique lateral interbody fusion (OLIF) and pos-terior lumbar interbody fusion (PLIF) for lumbar brucellosis spondylitis.PATIENTS AND METHODS: Between April 2018 and December 2021, 80 cases of lumbar bru-cellosis spondylitis admitted to our institution were evaluated for eligibility and randomly assigned to either PLIF (group A, lesion removal by posterior approach + interbody fusion + percutaneous pedi-cle screw internal fixation) or OLIF (group B, lesion removal by anterior approach + interbody fusion + percutaneous pedicle screw internal fixation). The outcome measures included operative time, intra-operative bleeding, hospital stay, preoperative and postoperative visual analogue scale (VAS) ratings, American Spinal Injury Association (ASIA) classifi-cation, Cobb angle, and interbody fusion time.RESULTS: PLIF resulted in shorter opera-tive time and hospital stay and less intraopera-tive bleeding vs. OLIF (p<0.05). All eligible pa-tients showed significantly lower VAS scores, and smaller ESR values and Cobb angles af -ter treatment (p<0.05), but no significant inter-group differences were observed (p>0.05). The two groups showed similar preoperative ASIA (American Spinal Injury Association) classifica-tion and interbody fusion time (p>0.05). PLIF was associated with better ASIA classification at three months postoperatively vs. OLIF (p<0.05).CONCLUSIONS: Both surgical techniques are efficient at removing the lesion, relieving pain, maintaining spinal stability, promoting implant fusion, and facilitating prognostic inflammation control. PLIF features a shorter surgical duration and hospital stay, less intraoperative bleeding, and greater neurological improvement vs. OLIF. Nevertheless, OLIF outperforms PLIF in the exci-sion of peri-vertebral abscesses. PLIF is indicat-ed for posterior spinal column lesions, particular-ly those with spinal nerve compression in the spi-nal canal, whereas OLIF is indicated for structur-al bone deterioration in the anterior column, par-ticularly for those with perivascular abscesses.