Oblique Lateral Interbody Fusion With Lateral Vertebral Screw Fixation Versus Transforaminal Lumbar Interbody Fusion for Severe Lumbar Stenosis: Results of a Multicenter Randomized Controlled Trial.
Xuefeng Li, Cheng Lin, Tangyiheng Chen et al.
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In 30 seconds
This prospective, multicenter randomized controlled trial compared oblique lateral interbody fusion with lateral vertebral screw fixation (OLIF) and transforaminal lumbar interbody fusion (TLIF) in adults with single-level severe lumbar stenosis and instability. Of 224 randomized patients, five were lost to follow-up. Both procedures produced significant, clinically meaningful improvements. OLIF was associated with shorter operative time, less blood loss, earlier ambulation, and shorter hospital stay; pain and disability improved earlier in some follow-up periods. Complication rates were similar: 7.3% with TLIF versus 5.5% with OLIF.
Key findings
- Both groups had significant, clinically meaningful improvements in pain and disability.
- OLIF was associated with shorter operative time, less blood loss, earlier ambulation, and shorter hospital stay (all P < .05).
- OLIF showed greater back pain reduction at 3-6 months and 2 years (P < .05), and greater ODI improvement at 3 and 6 months (P < .001); long-term ODI scores were similar.
- Complication rates were low and similar: 7.3% with TLIF versus 5.5% with OLIF; fusion rates were comparable at 1-2 years.
Why it matters
The trial suggests that both approaches can improve symptoms in severe lumbar stenosis with instability, while OLIF may offer perioperative advantages and faster early functional recovery. The similar long-term ODI scores, fusion rates, and complication rates help frame these benefits as differences in recovery and radiographic outcomes rather than evidence of broad long-term clinical superiority.
What to keep in mind
Five randomized patients were lost to follow-up. The abstract does not report the magnitude of between-group differences for the clinical outcomes.