Age-Related Differences in Clinical and Surgical Outcomes Following Oblique Lateral Interbody Fusion: A Retrospective Cohort Study

Abstract

Introduction We compared patient outcomes following oblique lateral interbody fusion (OLIF) for degenerative lumbar spine conditions among different age groups. Materials and Methods This retrospective cohort study included patients between January 2018 and July 2020. Patients were stratified into three groups based on age at the time of surgery (<65 years, 65 to <75 years, and ≥ 75 years). Preoperative and postoperative patient-reported outcome measures were assessed, including visual analog scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and EuroQol-5 Dimension (EQ-5D). Postoperative orthopedic events, including screw loosening, cage subsidence, and revision surgery, were recorded. All patients' survival status were followed until March 2023. Cox-proportional hazard models were conducted to examine the associations of age groups with postoperative orthopedic events and all-cause mortality. Results A total of 170 patients were analyzed (n=77, 68, and 25 for age <65 years, 65 to <75 years, and ≥ 75 years, respectively). VAS, ODI, and EQ-5D significantly improved after OLIF in all groups (all p<0.001). There were no significant differences in rates of postoperative screw loosening (p=0.702), cage subsidence (p=0.095), and revision surgery (p=0.265) across the three age groups. After a median follow up of 4.06 years, the three groups had no significant difference in orthopedic event-free survival (log-rank p=0.302). The findings were consistent after multivariate adjustment. Conclusion OLIF is a safe and effective surgical option for elderly patients with degenerative lumbar spine conditions.