Differences in radiographic and clinical outcomes of different oblique lumbar interbody fusions for lumbar degenerative diseases: a systematic review and Bayesian network meta-analysis.
Systematic Review
To systematically evaluate the differences in the clinical efficacy of lumbar degenerative disorders (LDDs) treatment between oblique lumbar interbody fusion with percutaneous pedicle screw fixation (OLIF-PF), OLIF stand-alone (OLIF-SA), and OLIF with anterolateral screw fixation (OLIF-AF). A systematic search was conducted on both English and Chinese databases, wherein the literature was screened based on title, abstract, and full text. Literature that met the inclusion criteria was assessed for quality and relevant information was extracted. The main outcome indicators were recorded and Bayesian network meta-analyses were performed. A thorough evaluation was conducted on the 12 papers that satisfied the inclusion criteria. Among these articles, 5 studies compared OLIF-PF with OLIF-SA, 5 studies compared OLIF-PF with OLIF-AF, and 2 studies compared OLIF-PF, OLIF-SA, and OLIF-AF. According to the included articles, a total of 758 people were treated with OLIF surgery (341 individuals covered in OLIF-PF group, 288 individuals covered in OLIF-SA group, and 129 individuals covered in OLIF-129 group). Pooled analysis showed that OLIF-PF performed better in terms of imaging outcomes compared to OLIF-SA and OLIF-AF. However, in terms of surgical duration and intraoperative blood loss, OLIF-PF showed a significant disadvantage compared to the other two surgical procedures. The ODI scores exhibited a preference for OLIF-AF, indicating a marginal superiority of OLIF-AF with regard to clinical outcomes. It is advisable for physicians to carefully select the most suitable OLIF procedure, taking into account their expertise and the individual requirements of each patient.
