Spine Journal - 2026-07-01 - Journal Article
Analysis of the efficacy of Endo-TLIF and OLIF-360 assisted by optical navigation in the treatment of degenerative lumbar spondylolisthesis lesions: a retrospective cohort study.
Yao Q, Wei Y, Wang M, Sun G, Liu M, Jiang Y, Su K, Lee JH, Farshad M, Wang Y, Ma X, Zhou C
Topics
Key Takeaway
Endo-TLIF produced greater CSA expansion and lower complication rates (4.0% vs 9.68%) than OLIF-360 for degenerative lumbar spondylolisthesis, while OLIF-360 achieved superior disc height and segmental lordosis restoration at minimum 2-year follow-up.
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Summary
This retrospective cohort compared optical navigation-assisted Endo-TLIF versus OLIF-360 in 194 patients with degenerative lumbar spondylolisthesis treated between 2020 and 2022. Endo-TLIF demonstrated superior perioperative metrics including less blood loss, shorter incision, and reduced hospital stay, with greater spinal canal CSA expansion. OLIF-360 produced significantly better disc height and segmental lordosis correction, with comparable fusion rates but higher overall complications (9.68% vs 4.0%), predominantly psoas injury and same-level restenosis.
Key Limitation
The absence of propensity score matching or randomization means systematic differences in patient selection between groups—such as degree of spondylolisthesis, canal stenosis severity, or disc height at baseline—likely confound the outcome comparisons.
Original Abstract
BACKGROUND CONTEXT
Endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) and oblique lumbar interbody fusion with percutaneous fixation (OLIF-360) are both minimally invasive fusion techniques for degenerative lumbar spondylolisthesis (DLS). Endo-TLIF provides direct decompression under endoscopic visualization, whereas OLIF-360 restores disc height and lumbar lordosis through indirect decompression. However, their relative advantages remain uncertain, particularly regarding perioperative outcomes and radiographic efficacy.
PURPOSE
To compare the clinical and radiographic outcomes of Endo-TLIF and OLIF-360 assisted by optical navigation in the management of DLS.
STUDY DESIGN
Retrospective cohort study.
PATIENT SAMPLE
A total of 101 patients treated by Endo-TLIF and 93 patients treated by OLIF-360.
OUTCOME MEASURES
Clinical records including the visual analog scale (VAS) score of the lower back and leg and the Oswestry disability index (ODI). Radiological records including disc height (DH), lumbar lordosis (LL), segmental lordosis (SL), the cross-sectional area (CSA) of the spinal canal, and fusion rate. Surgical-related information and complications were also recorded.
METHODS
A retrospective review was conducted of patients with DLS who underwent surgical treatment between 2020 and 2022 with a minimum follow-up of 2 years. A total of 194 patients were included, comprising 101 cases treated with endoscopic transforaminal lumbar interbody fusion (Endo-TLIF group) and 93 cases treated with oblique lateral interbody fusion combined with percutaneous pedicle screw fixation (OLIF-360 group). Perioperative outcomes, radiographic parameters, and complications were compared to evaluate the relative advantages and limitations of the two approaches.
RESULTS
The Endo-TLIF group had significantly less intraoperative blood loss, shorter incision length, and reduced hospital stay compared with the OLIF-360 group. Clinical scores improved significantly in both groups. The Endo-TLIF group showed better early postoperative mobilization, while functional outcomes were similar between groups at longer-term follow-up. CSA expansion was greater in the Endo-TLIF group, whereas improvements in DH and SL were more pronounced in the OLIF-360 group. Fusion rates at all postoperative time points were comparable between the 2 groups. The overall complication rates were 4.00% in the Endo-TLIF group and 9.68% in the OLIF-360 group, with Endo-TLIF showing a slightly lower incidence. Most complications in the OLIF-360 group were related to psoas muscle injury and recurrent same-level spinal canal stenosis.
CONCLUSIONS
This study demonstrates that both Endo-TLIF and OLIF-360 achieve favorable outcomes in the treatment of DLS. Compared with OLIF-360, Endo-TLIF offers advantages in earlier postoperative ambulation, shorter incision length, reduced intraoperative blood loss, and more direct spinal canal decompression. Conversely, OLIF-360 provides distinct benefits in restoring disc height, improving lumbar sagittal alignment, and promoting interbody fusion. Regarding complications, both approaches exhibited low incidence rates, with Endo-TLIF slightly lower than OLIF-360.