{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T16:07:43Z","timestamp":1776096463083,"version":"3.50.1"},"reference-count":60,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,9]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate the clinical and biomechanical effects of distinct anterolateral screw placement angles in oblique lumbar interbody fusion combined with anterolateral fixation (OLIF-AF), focusing on cage subsidence (CS) incidence, spinal stability, and optimal fixation strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patients who underwent OLIF-AF at a single center from December 2017 to November 2023 were retrospectively analyzed. Patients were divided into 4 groups (G0, G1, G2, and G3) based on the coronal plane angle (CPA) and relative horizontal plane angle. Preoperative and 1- or 3-day, 3-month, and 12-month postoperative radiological and clinical data were collected. A validated L4\u20135 finite element model simulated 4 screw configurations under 6 loading conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Eighty patients (49 female, mean age 64.5 \u00b1 7.1 years) were included in the analysis (28, 23, 15, and 14 patients in groups G0, G1, G2, and G3, respectively). CS occurred in 48.75% of patients, with significantly higher rates in the G2 (86.67%) and G3 (71.43%) versus G0 (28.57%) and G1 (34.78%) (p &lt; 0.05) groups. Compared with parallel CPA groups (G0 and G1), nonparallel CPA groups (G2 and G3) exhibited greater disc height (DH) reduction (\u0394DH range 3.1\u20133.4 mm vs 1.4\u20132.0 mm, p &lt; 0.05), higher cage stress (range 55.50\u201357.29 MPa vs 53.45\u201354.96 MPa), increased displacement (range 73.62\u201378.28 \u00d7 10\n                      <jats:sup>\u22122<\/jats:sup>\n                      mm vs 72.21\u201372.37 \u00d7 10\n                      <jats:sup>\u22122<\/jats:sup>\n                      mm), and elevated range of motion (ROM) in flexion. Clinical scores (visual analog scale and Oswestry Disability Index) were not different between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>OLIF-AF with parallel screw placement in the coronal plane (G0 and G1) reduced CS risk and enhanced biomechanical stability by minimizing cage stress, displacement, and ROM. Horizontal screw bifurcation (G1 vs G0) did not demonstrate a statistically significant association with CS risk. Furthermore, there were no significant differences in fusion rates or clinical outcome measurements at different angles of AF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.8.spine25453","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:00:12Z","timestamp":1769083212000},"page":"436-448","source":"Crossref","is-referenced-by-count":0,"title":["Comprehensive analysis of biomechanical stability and clinical efficacy in oblique lumbar interbody fusion with distinct anterolateral fixation modalities"],"prefix":"10.3171","volume":"44","author":[{"given":"Lingcong","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Sichuan Provincial People\u2019s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenjie","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sichuan Provincial People\u2019s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caiyuan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sichuan Provincial People\u2019s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ke","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sichuan Provincial People\u2019s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niezhenghao","family":"He","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sichuan Provincial People\u2019s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenao","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sichuan Provincial People\u2019s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sichuan Provincial People\u2019s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sichuan Provincial People\u2019s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiang","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sichuan Provincial People\u2019s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haowen","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sichuan Provincial People\u2019s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan; and"},{"name":"Department of Orthopedics, Sichuan East Hospital, Sichuan Provincial People\u2019s Hospital, The First People\u2019s Hospital of Dazhou, Sichuan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"Sovrem Tekhnologii Med","first-page":"70","article-title":"Lumbar spinal fusion using lateral oblique (pre-psoas) approach (review)","volume":"13","author":"Aleinik AY","year":"2021","unstructured":"Aleinik AY, Mlyavykh SG, Qureshi S. Lumbar spinal fusion using lateral oblique (pre-psoas) approach (review). Sovrem Tekhnologii Med. 2021;13(5):70\u201381."},{"issue":"6","key":"b2","series-title":"Ann Transl Med","first-page":"104","article-title":"Minimally invasive anterior, lateral, and oblique lumbar interbody fusion: a literature review","volume":"6","author":"Xu DS","year":"2018","unstructured":"Xu DS, Walker CT, Godzik J, Turner JD, Smith W, Uribe JS. Minimally invasive anterior, lateral, and oblique lumbar interbody fusion: a literature review. Ann Transl Med. 2018;6(6):104."},{"key":"b3","series-title":"World Neurosurg","first-page":"e204","article-title":"Biomechanical comparison of stand-alone and bilateral pedicle screw fixation for oblique lumbar interbody fusion surgery\u2014a finite element analysis","volume":"141","author":"Fang G","year":"2020","unstructured":"Fang G, Lin Y, Wu J,  Biomechanical comparison of stand-alone and bilateral pedicle screw fixation for oblique lumbar interbody fusion surgery\u2014a finite element analysis. World Neurosurg. 2020;141:e204\u2013e212."},{"key":"b4","series-title":"Med Sci Monit","first-page":"e934985","article-title":"Oblique lateral interbody fusion with anterolateral screw fixation is as effective as with posterior percutaneous pedicle screw fixation in treating single-segment mild degenerative lumbar diseases","volume":"28","author":"Guo Y","year":"2022","unstructured":"Guo Y, Wang X, Li Y,  Oblique lateral interbody fusion with anterolateral screw fixation is as effective as with posterior percutaneous pedicle screw fixation in treating single-segment mild degenerative lumbar diseases. Med Sci Monit. 2022;28:e934985."},{"issue":"1","key":"b5","series-title":"Spine (Phila Pa 1976)","first-page":"55","article-title":"Perioperative complications in 155 patients who underwent oblique lateral interbody fusion surgery: perspectives and indications from a retrospective, multicenter survey","volume":"42","author":"Abe K","year":"2017","unstructured":"Abe K, Orita S, Mannoji C,  Perioperative complications in 155 patients who underwent oblique lateral interbody fusion surgery: perspectives and indications from a retrospective, multicenter survey. 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J Neurosurg Spine. 2015;23(5):589\u2013597."},{"issue":"3","key":"b8","series-title":"Medicina (Kaunas)","first-page":"378","article-title":"The evolution of lateral lumbar interbody fusion: a journey from past to present","volume":"60","author":"Wong AXJ","year":"2024","unstructured":"Wong AXJ, Tang DH, Kaliya-Perumal AK, Oh JY. The evolution of lateral lumbar interbody fusion: a journey from past to present. Medicina (Kaunas). 2024;60(3):378."},{"key":"b9","series-title":"Front Bioeng Biotechnol","first-page":"1075574","article-title":"Endplate volumetric bone mineral density biomechanically matched interbody cage","volume":"10","author":"Weng Y","year":"2022","unstructured":"Weng Y, Di M, Wu T, Ma X, Yang Q, Lu WW. Endplate volumetric bone mineral density biomechanically matched interbody cage. Front Bioeng Biotechnol. 2022;10:1075574."},{"issue":"12","key":"b10","series-title":"Orthop Surg","first-page":"3263","article-title":"The influence of screw positioning on cage subsidence in patients with oblique lumbar interbody fusion combined with anterolateral fixation","volume":"15","author":"Wang K","year":"2023","unstructured":"Wang K, Wang X, Li Z,  The influence of screw positioning on cage subsidence in patients with oblique lumbar interbody fusion combined with anterolateral fixation. Orthop Surg. 2023;15(12):3263\u20133271."},{"issue":"Suppl 3","key":"b11","series-title":"Eur Spine J","first-page":"414","article-title":"Impaired bone mineral density as a predictor of graft subsidence following minimally invasive transpsoas lateral lumbar interbody fusion","volume":"24","author":"Tempel ZJ","year":"2015","unstructured":"Tempel ZJ, Gandhoke GS, Okonkwo DO, Kanter AS. 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Sovrem Tekhnologii Med. 2021;13(5):70\u201381."},{"issue":"6","key":"b2","series-title":"Ann Transl Med","first-page":"104","article-title":"Minimally invasive anterior, lateral, and oblique lumbar interbody fusion: a literature review","volume":"6","author":"Xu DS","year":"2018","unstructured":"Xu DS, Walker CT, Godzik J, Turner JD, Smith W, Uribe JS. Minimally invasive anterior, lateral, and oblique lumbar interbody fusion: a literature review. Ann Transl Med. 2018;6(6):104."},{"key":"b3","series-title":"World Neurosurg","first-page":"e204","article-title":"Biomechanical comparison of stand-alone and bilateral pedicle screw fixation for oblique lumbar interbody fusion surgery\u2014a finite element analysis","volume":"141","author":"Fang G","year":"2020","unstructured":"Fang G, Lin Y, Wu J,  Biomechanical comparison of stand-alone and bilateral pedicle screw fixation for oblique lumbar interbody fusion surgery\u2014a finite element analysis. World Neurosurg. 2020;141:e204\u2013e212."},{"key":"b4","series-title":"Med Sci Monit","first-page":"e934985","article-title":"Oblique lateral interbody fusion with anterolateral screw fixation is as effective as with posterior percutaneous pedicle screw fixation in treating single-segment mild degenerative lumbar diseases","volume":"28","author":"Guo Y","year":"2022","unstructured":"Guo Y, Wang X, Li Y,  Oblique lateral interbody fusion with anterolateral screw fixation is as effective as with posterior percutaneous pedicle screw fixation in treating single-segment mild degenerative lumbar diseases. Med Sci Monit. 2022;28:e934985."},{"issue":"1","key":"b5","series-title":"Spine (Phila Pa 1976)","first-page":"55","article-title":"Perioperative complications in 155 patients who underwent oblique lateral interbody fusion surgery: perspectives and indications from a retrospective, multicenter survey","volume":"42","author":"Abe K","year":"2017","unstructured":"Abe K, Orita S, Mannoji C,  Perioperative complications in 155 patients who underwent oblique lateral interbody fusion surgery: perspectives and indications from a retrospective, multicenter survey. Spine (Phila Pa 1976). 2017;42(1):55\u201362."},{"issue":"7","key":"b6","series-title":"Global Spine J","first-page":"1981","article-title":"Subsidence of interbody cage following oblique lateral interbody fusion: an analysis and potential risk factors","volume":"13","author":"Kotheeranurak V","year":"2023","unstructured":"Kotheeranurak V, Jitpakdee K, Lin GX,  Subsidence of interbody cage following oblique lateral interbody fusion: an analysis and potential risk factors. Global Spine J. 2023;13(7):1981\u20131991."},{"issue":"5","key":"b7","series-title":"J Neurosurg Spine","first-page":"589","article-title":"Assessment and classification of subsidence after lateral interbody fusion using serial computed tomography","volume":"23","author":"Malham GM","year":"2015","unstructured":"Malham GM, Parker RM, Blecher CM, Seex KA. Assessment and classification of subsidence after lateral interbody fusion using serial computed tomography. J Neurosurg Spine. 2015;23(5):589\u2013597."},{"issue":"3","key":"b8","series-title":"Medicina (Kaunas)","first-page":"378","article-title":"The evolution of lateral lumbar interbody fusion: a journey from past to present","volume":"60","author":"Wong AXJ","year":"2024","unstructured":"Wong AXJ, Tang DH, Kaliya-Perumal AK, Oh JY. The evolution of lateral lumbar interbody fusion: a journey from past to present. Medicina (Kaunas). 2024;60(3):378."},{"key":"b9","series-title":"Front Bioeng Biotechnol","first-page":"1075574","article-title":"Endplate volumetric bone mineral density biomechanically matched interbody cage","volume":"10","author":"Weng Y","year":"2022","unstructured":"Weng Y, Di M, Wu T, Ma X, Yang Q, Lu WW. Endplate volumetric bone mineral density biomechanically matched interbody cage. Front Bioeng Biotechnol. 2022;10:1075574."},{"issue":"12","key":"b10","series-title":"Orthop Surg","first-page":"3263","article-title":"The influence of screw positioning on cage subsidence in patients with oblique lumbar interbody fusion combined with anterolateral fixation","volume":"15","author":"Wang K","year":"2023","unstructured":"Wang K, Wang X, Li Z,  The influence of screw positioning on cage subsidence in patients with oblique lumbar interbody fusion combined with anterolateral fixation. Orthop Surg. 2023;15(12):3263\u20133271."},{"issue":"Suppl 3","key":"b11","series-title":"Eur Spine J","first-page":"414","article-title":"Impaired bone mineral density as a predictor of graft subsidence following minimally invasive transpsoas lateral lumbar interbody fusion","volume":"24","author":"Tempel ZJ","year":"2015","unstructured":"Tempel ZJ, Gandhoke GS, Okonkwo DO, Kanter AS. Impaired bone mineral density as a predictor of graft subsidence following minimally invasive transpsoas lateral lumbar interbody fusion. Eur Spine J. 2015;24 Suppl 3:414\u2013419."},{"issue":"4","key":"b12","series-title":"Spine J","first-page":"523","article-title":"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","volume":"23","author":"Li Z","year":"2023","unstructured":"Li Z, Wang X, Xie T,  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. Spine J. 2023;23(4):523\u2013532."},{"issue":"6","key":"b13","series-title":"Spine J","first-page":"993","article-title":"Comparing the medium-term outcomes of lumbar interbody fusion via transforaminal and oblique approach in treating lumbar degenerative disc diseases","volume":"22","author":"Zhao L","year":"2022","unstructured":"Zhao L, Xie T, Wang X,  Comparing the medium-term outcomes of lumbar interbody fusion via transforaminal and oblique approach in treating lumbar degenerative disc diseases. 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