Safety Analysis of Two Anterior Lateral Lumbar Interbody Fusions at the Initial Stage of Learning Curve

Objective: Until now, there were few studies on the safety analysis of oblique lumbar interbody fusion (OLIF) and extreme lateral interbody fusion (XLIF) in the initial stage of learning curve. The purpose of this study was to find out the safety differences between the 2 minimally invasive fusion methods in the initial stage of learning curve and to provide reference for beginners.

Methods: We retrospectively collected the first 30 cases of lumbar degenerative disease with OLIF or XLIF in our center since June 2014. Patients were divided into group OLIF and group XLIF according to different operative methods. The clinical efficacy and complications of the 2 groups were compared. A P <0.05 was statistically significant.

Results: Group XLIF were aged 37-74 years (mean 58.4 years) and group OLIF were aged 39-71 years (mean 56.1 years). There were no significant differences between the 2 groups in age, sex, operation time, intraoperative bleeding volume, operation segment, and follow-up time. The incidence of complications in group XLIF was significantly lower than that in group OLIF (10% vs. 33.3%; P = 0.028).

Conclusions: OLIF has a higher risk of neurovascular injury in the initial stage of learning. By contrast, the XLIF approach is simple and the incidence of complications is relatively low. Therefore, we believed that XLIF is more acceptable in the initial stage of anterolateral lumbar interbody fusion.