Study design:

A retrospective cohort study.

Purpose:

To evaluate the efficacy and safety of midline lumbar fusion (MIDLF) for lumbosacral fusion compared to posterior lumbar interbody fusion (PLIF).

Methods:

Patients undergone posterior lumbosacral fusion surgery were divided into a MIDLF group (n = 37) and a PLIF group (n = 42). The follow-up time was at least 12 months. The operation data, recovery condition, complications, clinical outcomes, and status of implants and fusion were compared between the two groups.

Results:

The MIDLF group experienced significantly less blood loss, lower postoperative creatine kinase levels and total drainage volume, earlier time to ambulation, and less hospital stay times after surgery compared to the PLIF group (P < 0.05). The mean postoperative back pain visual analog scale scores in the MIDLF group were significantly lower than the PLIF group (P < 0.05). The improvement in Oswestry Disability Index scores during three-month follow-up displayed a significant difference between the two groups (P<0.05). The fusion rate tended to be higher in the MIDLF group, however, the difference was not significant(P>0.05). The was no significant difference in respect of screw loosening and cage subsidence rate. There were two cases of complications both occurring in the PLIF group.

Conclusion:

MIDLF is safe and effective for lumbosacral fusion and in line with the concept of enhanced recovery after surgery.