Postoperative Delirium After OLIF-PPSF Versus TLIF: A Propensity Score-Matched Analysis over 16 Years

Background/Objectives: Postoperative delirium is a clinically important complication after lumbar fusion surgery, yet whether the choice of fusion technique influences its occurrence remains unclear. We compared the incidence of postoperative delirium between oblique lateral interbody fusion with percutaneous pedicle screw fixation (OLIF-PPSF) and transforaminal lumbar interbody fusion (TLIF).

Methods

The medical records of 850 patients (335 OLIF-PPSF, 515 TLIF) treated between 2008 and 2023 were retrospectively reviewed; 487 patients were eligible, and propensity score matching yielded 141 matched pairs. Delirium was identified through symptom-triggered psychiatric consultation rather than routine screening. Analyses were stratified by treatment era and repeated within the period in which both procedures were performed.