Restoration of Segmental Lordosis and Lumbar Lordosis after Oblique Lumbar Interbody Fusion

Abstract Background: Oblique lumbar interbody fusion (OLIF) can restore segmental lordosis (SL) and lumbar lordosis (LL) in a minimally invasive manner. This study aims to measure changes in SL and LL after OLIF and to evaluate the change in SL concerning intervertebral cage position. Materials and Methods: Retrospectively, we reviewed lumbar degenerative disease patients who underwent OLIF surgery from 2016 to 2020. We compared preoperative and postoperative SL and LL on plain radiographs, computed tomography scans, and magnetic resonance imaging scans. We also evaluated the cage position in the intervertebral disc space, which was divided into anterior, middle, and posterior. Results: A total of 80 patients were enrolled in the study. A total of 103 lumbar levels were assessed. Of these, 72 levels at L4/L5, 22 levels at L3/L4, 6 levels at L2/L3, 2 levels at L1/L2, and 1 level at L5/S1 were assessed. The change in SL postoperatively versus preoperatively was noted to be statistically significant ( P < 0.05). The mean change in SL from preoperative to postoperative was 5.23 ± 3.98. In our study, based on the cage position, the mean change in the SL in the anterior, middle, and posterior was 6.29 ± 2.23, 4.31 ± 1.98, and 2.71 ± 1.47. The mean change in overall LL was 2.83 ± 1.78. Conclusion: Our study determined that OLIF improves SL and LL. A detailed analysis of cage position showed that anterior and middle cage positions had a significantly higher change in SL than posterior cage. Maximum mean change in SL from preoperative to postoperative was seen in the anterior cage.