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Fusion’s Location and Quality within the Fixated Segment Following Transforaminal Interbody Fusion (TLIF) – Lumbar Fusion

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The article discusses the use of transforaminal interbody fusion (TLIF) as a surgical treatment for various lumbar spine conditions. The study evaluated post-operative computed tomography (CT) scans of patients who underwent TLIF surgery at a medical center between 2010 and 2020. The researchers assessed the fusion quality in the posterolateral and intervertebral body areas using Lee’s criteria. The study included 48 patients with a median age of 55.6 years. The results showed that 48% of patients had full definitive fusion in both areas, and 92% had definitive fusion in at least one area. The posterolateral area had a significantly higher fusion rate compared to the intervertebral body area in long-term follow-up. The study suggests that surgeons should consider using bone augmentation material in the posterolateral area as the primary site of fusion when performing TLIF surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top spinal hospital on Harley Street UK

Published article

Transforaminal interbody fusion (TLIF) has gained increased popularity over recent decades and is being employed as an established surgical treatment for several lumbar spine pathologies, including degenerative spondylosis, spondylolisthesis, infection, tumor and some cases of recurrent disc herniation. Despite the seemingly acceptable fusion rates after TLIF (up to 94%), the literature is still limited regarding the specific location and quality of fusion inside the fixated segment. In this…

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Healthcare (Basel). 2023 Oct 24;11(21):2814. doi: 10.3390/healthcare11212814.ABSTRACTTransforaminal interbody fusion (TLIF) has gained increased popularity over recent decades and is being employed as an established surgical treatment for several lumbar spine pathologies, including degenerative spondylosis, spondylolisthesis, infection, tumor and some cases of recurrent disc herniation. Despite the seemingly acceptable fusion rates after TLIF (up to 94%),

Healthcare (Basel). 2023 Oct 24;11(21):2814. doi: 10.3390/healthcare11212814.

ABSTRACT

Transforaminal interbody fusion (TLIF) has gained increased popularity over recent decades and is being employed as an established surgical treatment for several lumbar spine pathologies, including degenerative spondylosis, spondylolisthesis, infection, tumor and some cases of recurrent disc herniation. Despite the seemingly acceptable fusion rates after TLIF (up to 94%), the literature is still limited regarding the specific location and quality of fusion inside the fixated segment. In this single-institution, retrospective population-based study, we evaluated all post-operative computed tomography (CT) of patients who underwent TLIF surgery at a medium-sized medical center between 2010 and 2020. All CT studies were performed at a minimum of 1 year following the surgery, with a median of 2 years. Each CT study was evaluated for post-operative fusion, specifically in the posterolateral and intervertebral body areas. The fusion’s quality was determined and classified in each area according to Lee’s criteria, as follows: (1) definitive fusion: definitive bony trabecular bridging across the graft host interface; (2) probable fusion: no definitive bony trabecular crossing but with no gap at the graft host interface; (3) possible arthrosis: no bony trabecular crossing with identifiable gap at the graft host interface; (4) definite pseudarthrosis: no traversing trabecular bone with definitive gap. A total of 48 patients were included in this study. The median age was 55.6 years (SD ± 15.4). The median time from surgery to post-operative CT was 2 years (range: 1-10). Full definitive fusion in both posterolateral and intervertebral areas was observed in 48% of patients, and 92% showed definitive fusion in at least one area (either posterolateral or intervertebral body area). When comparing the posterolateral and the intervertebral area fusion rates, a significantly higher definitive fusion rate was observed in the posterolateral area as compared to the intervertebral body area in the long term follow-up (92% vs. 52%, p < 0.001). In the multivariable analysis, accounting for several confounding factors, including the number of fixated segments and cage size, the results remained statistically significant (p = 0.048). In , a significantly higher definitive fusion rate at the posterolateral area compared to the intervertebral body area following TLIF surgery was found. Surgeons are encouraged to employ bone augmentation material in the posterolateral area (as the primary site of fusion) when performing TLIF surgery.

PMID:37957959 | DOI:10.3390/healthcare11212814

The London Spine Unit : top spinal hospital on Harley Street UK

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Fusion’s Location and Quality within the Fixated Segment Following Transforaminal Interbody Fusion (TLIF)

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Healthcare (Basel). 2023 Oct 24;11(21):2814. doi: 10.3390/healthcare11212814.ABSTRACTTransforaminal interbody fusion (TLIF) has gained increased popularity over recent decades and is being employed as an established surgical treatment for several lumbar spine pathologies, including degenerative spondylosis, spondylolisthesis, infection, tumor and some cases of recurrent disc herniation. Despite the seemingly acceptable fusion rates after TLIF (up to 94%)

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