Effect of Different Minimally Invasive Posterior Stabilization Techniques After Direct Lateral Interbody Fusion With Long-Term Clinical and Radiological Outcomes in Railway Workers: A Retrospective Single-Center Study

Byvaltsev V.A. Kalinin A.A. Pestryakov Y.Y. Aliyev M.A. Yuldashev R.M. Dyussembekov Y.K. Riew K.D.
September 2025 SAGE Publications Ltd

Global Spine Journal
2025 #15 Issue 8 3729 - 3742 pp.

Study Design: Retrospective study. Objective: To investigate the clinical and radiological outcomes of patients with lumbar degenerative disc disease (DDD) treated with one-level Direct lateral interbody fusion (DLIF) in combination with minimally invasive percutaneous pedicle screw fixation (PPSF) and percutaneous facet joint fixation (PFJF). Methods: This retrospective single-center study included 98 patients (67 men, 31 women) aged 28 to 59 years with one level lumbar DDD with foraminal and central stenosis, were divided into groups after DLIF: PPSF (n = 50) and PFJF (n = 48). Intraoperative parameters, perioperative clinical data and radiological assessment with X-ray, MRI and CT were used before operation and mean 45-month follow-up. Workload intensity criteria were used to analyze return to work rate. Results: The DLIF-PFJF group had significantly shorter surgery time (P = .04), duration of anesthesia (P = .02), X-ray time (P = .02), less back pain (P = .03), better functional status according to ODI (P = .04) and SF-36 PCS (P = .04), less atrophic changes in the multifidus muscle compared with DLIF-PPSF. There were no statistically significant differences in the volume of blood loss, duration of inpatient treatment, VAS leg pain, SF-36 MCS, Macnab results, mean disc height, intervertebral foramen height, sagittal disc angle, global lumbar lordosis, fusion rate, and the number of complications. In heavy/very heavy workload patients, the DLIF-PFJF had a statistically significantly higher rate of return to work compared to the DLIF-PPSF group. Conclusions: DLIF-PFJF appears to be superior to DLIF-PPSF, minimizing invasiveness, which significantly reduces the damage to the paraspinal muscles and also has significant long-term clinical advantages and return to work rates. Both minimally invasive techniques have comparable radiographic parameters, including the height of the intervertebral foramen and disc, fusion rates, global and segmental sagittal correction after surgery.

degenerative disk disease , direct lumbar interbody fusion , facet joint fixation , lumbar spine , MISS , pedicle screw fixation , return to work , workload intensity

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Department of Neurosurgery, Irkutsk State Medical University, Irkutsk, Russian Federation
Department of Neurosurgery, Railway Clinical Hospital, Irkutsk, Russian Federation
Department of Traumatology, Orthopedic and Neurosurgery, Irkutsk State Medical Academy of Postgraduate Education, Irkutsk, Russian Federation
Department of Neurosurgery, Kazakhstan-Russian Medical University, Almaty, Kazakhstan
Department of Spine and Spinal Cord Pathology, Republican Specialized Scientific and Practical Medical Center for Neurosurgery of the Ministry of Health of the Republic of Uzbekistan, Tashkent, Uzbekistan
Department of Neurosurgery, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Department of Neurological Surgery, Weill Cornell Medical School, New York, United States
Department of Orthopedic Surgery, Columbia University, New York, United States

Department of Neurosurgery
Department of Neurosurgery
Department of Traumatology
Department of Neurosurgery
Department of Spine and Spinal Cord Pathology
Department of Neurosurgery
Department of Neurological Surgery
Department of Orthopedic Surgery

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