Supine ALIF versus Lateral-Decubitus OLIF for Degenerative Lumbar Disease
Spine · 15 Oct 2026
† Impact is the editorial-priority score. All scores are out of 100. Clinical is a stored clinical-importance score from the earlier method; it has not been recalculated.
Why it matters
ALIF and OLIF are both common anterior-column fusion approaches, so knowing that neither shows a clear complication or patient-reported outcome advantage in retrospective data helps frame approach selection and patient counselling.
The evidence
This meta-analysis pooled 13 retrospective studies (1,432 patients) that directly compared supine anterior lumbar interbody fusion (ALIF) with lateral-decubitus oblique lumbar interbody fusion (OLIF) for degenerative lumbar disease. OLIF was associated with about a one-day shorter hospital stay (mean difference -0.87 days, 95% CI -1.47 to -0.26) and greater reduction in sagittal vertical axis. Operative time and blood loss favoured OLIF only after an outlier study was removed, and complications and patient-reported pain and disability did not differ.
A coherent primary effect estimate is unavailable. Clinical relevance does not estimate treatment benefit.
Why this rigour score?
Meta-analysis of observational studiesDesign starting point: 37.4
Raised the score
- Compared against current standard of care+3.4
- Comprehensive literature search+3.4
Lowered the score
- Pools observational studies−6.8
- No assessment of publication bias across 13 studies−6.8
Methods at a glance
Recorded assessment- Comprehensive literature searchMet
- Risk of bias assessedMet
- Bias considered in synthesisMet
- Publication bias assessedNot met
- Study exclusions justifiedNot met
- Prospective registrationNot reported
Not reported does not mean not done. Checks have different weights; this is not a count of boxes ticked.
See the full score breakdown
- Study design starting point
- 37.4
- Compared against current standard of care
- +3.4
- Pools observational studies
- −6.8
- Comprehensive literature search
- +3.4
- Risk of bias assessed in the included studies
- +3.4
- Risk of bias carried into the synthesis
- +2.5
- No assessment of publication bias across 13 studies
- −6.8
- Final rigour score rounded
- 37 / 100
Study design sets the starting point and a ceiling of 78. Recorded methods then adjust the score. Points are shown to one decimal place; the final score uses unrounded values.
Checklist from the stored appraisal. “Not met” describes the recorded criterion; it does not always produce a deduction. This overview supports reading the full study.
For journal club
1.For an older patient with significant comorbidities who needs an L5-S1 interbody fusion, how would you weigh OLIF's possibly shorter stay against the reported level-specific vascular risk at L5-S1?
2.If a patient's main goal is pain and disability relief rather than global alignment correction, does a greater SVA reduction with OLIF justify choosing it over ALIF?
Original publication title
Supine ALIF versus Lateral-Decubitus OLIF for Degenerative Lumbar Disease