Facet-Sparing Trans-Kambin Lumbar Interbody Fusion Versus Oblique Lumbar Interbody Fusion (Anterior-to-Psoas): Effect on Disc Height, Segmental Lordosis, and Lumbar Lordosis – Retrospective Case Series

Objective: The aim of this study was to compare the effect on disc height (DH), segmental lordosis (SL), and lumbar lordosis (LL) between trans-Kambin lumbar interbody fusion (KLIF) and oblique lumbar interbody fusion (OLIF) procedures. Facet-sparing KLIF and OLIF are techniques of spinal fusion that rely on the principle of indirect decompression. Both procedures can restore DH, SL, and LL in a minimally invasive manner. However, approach-related complications and the need to change position for screw placement are some of the disadvantages of OLIF. In contrast, KLIF can be done in a single position, overcoming the aforementioned complications.Methods: This retrospective study included patients who had undergone KLIF and OLIF. DH, SL, and LL were measured on preoperative and postoperative x-rays using Surgimap software. DH was measured as the average of anterior and posterior DHs. Clinical evaluation was done using modified MacNab grading. Statistical analysis was conducted using the Mann-Whitney test.Results: Fifty segments each of KLIF (41 patients) and OLIF (35 patients) were included in our study. The average percentage increase in DH in KLIF group was 58.25% versus 103.41% in OLIF group. The change in SL was 3.16° in the KLIF group and 5.36° in the OLIF group. The LL change was 2.73° in the KLIF group and 3.79° in the OLIF group. Modified MacNab grading did not show any significant difference in the outcome scores in both procedures.Conclusion: Our study showed that both KLIF and OLIF can effectively help restore DH, SL, and LL. Furthermore, OLIF enabled significantly greater correction of SL and LL due to the lordotic cage design and effective compression maneuver of percutaneous fixation on the anterior fulcrum on the cage.