Twelve-Month Comparative Efficacy of Lumbar Fusion and Radiofrequency Ablation in the Management of Lumbar Disc Herniation: A Retrospective Cohort Study.

Abstract

A retrospective cohort study. To compare the clinical and radiologic outcomes of these treatments, focusing on functional recovery, intervertebral space height, spondylolisthesis reduction, and complication rates. Lumbar disc herniation (LDH) is a leading cause of disability worldwide, necessitating effective interventions to restore function and alleviate pain. Radiofrequency ablation and lumbar fusion are common interventions, yet their comparative efficacy remains underexplored. A retrospective cohort study of 330 LDH patients was conducted. Patients were divided into a control group (radiofrequency ablation, n=264) and a study group (lumbar fusion, n=66). Outcomes were assessed using the Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) scores, intervertebral space height, and spondylolisthesis grade. Clinical efficacy was categorized as "excellent," "good," "fair," or "poor," with total efficacy rates calculated. Complications and fusion rates were analyzed using SPSS 23.0, with P<0.05 considered significant. Lumbar fusion showed superior functional recovery (ODI: 35.27±5.05 to 12.39±2.46; JOA: 8.08±1.79 to 29.68±4.25, P<0.001) compared with radiofrequency ablation (ODI: 35.59±5.43 to 26.49±3.65; JOA: 7.66±1.75 to 18.81±2.50). Fusion maintained better intervertebral space height, achieved greater spondylolisthesis reduction, and had fewer complications (7.57% vs. 11.36%, P=0.049) with a higher fusion rate (96.96%). Lumbar fusion offers superior functional and structural outcomes, with fewer complications compared with radiofrequency ablation, particularly in advanced LDH cases, while ablation remains a viable minimally invasive option for early-stage LDH.