Oblique lumbar interbody fusion combined with stress end plate augmentation and anterolateral screw fixation for degenerative lumbar spinal stenosis with osteoporosis: a matched-pair case-controlled study

Oblique lumbar interbody fusion (OLIF) has been proven to be effective in treating degenerative lumbar spinal stenosis (DLSS). Whether OLIF is suitable for treating patients with DLSS with osteoporosis (OP) is still controversial. Bone cement augmentation is widely used to enhance the internal fixation strength of osteoporotic spines. However, the effectiveness of OLIF combined with bone cement stress end plate augmentation (SEA) and anterolateral screw fixation (AF) for DLSS with OP have not confirmed yet. To evaluate the clinical, radiological, and functional outcomes of OLIF-AF versus OLIF-AF-SEA in the treatment of DLSS with OP. Retrospective case-control study. A total of 60 patients with OP managed for DLSS at L4–L5. Visual analog scale (VAS) score of the lower back and leg, Oswestry Disability Index (ODI), disk height (DH), lumbar lordosis (LL), segmental lordosis (SL), cage subsidence and fusion rate. The study was performed as a retrospective matched-pair case‒controlled study. Patients with OP managed for DLSS at L4–L5 between October 2017 and June 2020 and completed at least 2 years of follow-up were included, which were 30 patients treated by OLIF-AF and 30 patients undergoing OLIF-AF-SEA. The demographics and radiographic data, fusion status and functional outcomes were therefore compared to evaluate the efficacy of the two approaches. Pain and disability improved similarly in both groups at the 24-month follow-up. However, the SEA group had lower pain and functional disability at 3 months postoperatively (p