Objective:

Oblique lumbar interbody fusion (OLIF) is useful as surgical treatment for degenerative lumbar disease. However, revision surgery often has worse surgical outcomes than primary surgery. We here compared the usefulness of OLIF as a primary or a revision surgery.

Methods:

We retrospectively investigated 173 patients who underwent single-level OLIF during 2016‒2018. Radiological and clinical outcomes were compared between primary surgery (PS; n = 152) and revision surgery (RS; n = 21) groups. The effect of revision surgery on clinical outcome (Oswestry Disability Index [ODI] cut-off = 12) post-surgery were investigated.

Results:

The ODI, visual analog scale (VAS) score of 6- and 12-months post-surgery was worse in the RS than in the PS group (p < 0.05). In the RS group, leg VAS score of the previous laminectomy side was worse than that of the virgin side at 6- and 12-months post-surgery (p < 0.05). Disc height, ligamentum flavum, and subsidence did not differ between groups. However, cross-sectional area enlargement differed between groups (p < 0.05). Multivariate logistic regression analysis showed that revision surgery and severe subsidence were risk factors for ODI differences (p = 0.006 and 0.017, respectively).

Conclusions:

Most radiological outcomes were similar in revision and primary surgeries, and there were no differences in complications or additional posterior decompression. However, OLIF had relatively poor clinical outcomes as a revision surgery. Revision spine surgery tends to have poor outcomes compared to primary spine surgery, but OLIF can be a tolerable option as revision spine surgery.