ABSTRACT
Background:
One of the most frequent etiologies for spinal
surgery is unstable lumbar
spondylolisthesis (ULS). To decompress affected structures while maintaining or restoring stability through fusion,
surgeons utilize a variety of
procedures. When paired with interbody fusion, posterior fusion is most applied, resulting in greater fusion rates. The two most popular
techniques for implementing
spinal fusion are posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF). As a result, these two
procedures have been assessed formally.
Methodology:
A retrospective
analysis of
patients who underwent interbody fusion for lumbar
stenosis through PLIF and minimally invasive (MI)-TLIF was performed. The
patients were followed up for 24 months and fusion rates, Visual Analog Score (VAS), and Oswestry Disability Index (ODI) alongside the MacNab clinical outcome score, were assessed. The Bridwell interbody fusion grading system was used to evaluate fusion rates in computed
tomography (CT).
Results:
Operations were performed in 60 cases where
patients suffered from ULS. PLIF was performed on 33
patients (55%) (14
males and 19
females) and 27
patients (45%) (11
males and 16
females)
who underwent MI-TLIF. In 87% of our respective cohort, either the L4-5 or the L5-S1 level was operated on. Overall fusion rates were comparable between the two groups; however, the TLIF group improved more in terms of VAS, ODI, and MacNab scores. On average, MI-TLIF
surgery was longer and resulted in reduced
blood loss. MI-TLIF
patients were more mobile than PLIF
patients postoperatively.
Conclusion:
With well-established adequate results in the
literature, TLIF offers benefits over other
methods used for interbody lumbar fusion in ULS or other
diseases of the
spine. However, MI-TLIF may procure more advantageous for
patients if MI
methods are implemented. In this instance, TLIF outperformed PLIF due to shorter operating times, less
blood loss, faster ODI recovery, better MacNab scores, and a greater decline in VAS
pain ratings.