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Management of lumbar spondylolisthesis: A retrospective analysis of posterior lumbar interbody fusion versus transforaminal lumbar interbody fusion – Lumbar Fusion

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The article discusses the use of posterior lumbar interbody fusion (PLIF) and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) in treating unstable lumbar spondylolisthesis (ULS). A retrospective analysis of patients who underwent these procedures was conducted, with outcomes including fusion rates, pain scores, disability index, and clinical outcome scores. While fusion rates were similar for both procedures, the MI-TLIF group showed greater improvement in pain, disability, and clinical outcomes. MI-TLIF also resulted in shorter operation times, less blood loss, and faster recovery compared to PLIF. The study concludes that TLIF, especially when using minimally invasive techniques, may offer more benefits and better outcomes for patients with ULS or other spinal conditions

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

: 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.

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J Craniovertebr Junction Spine. 2024 Jan-Mar;15(1):99-104. doi: 10.4103/jcvjs.jcvjs_74_23. Epub 2024 Mar 13. 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,

J Craniovertebr Junction Spine. 2024 Jan-Mar;15(1):99-104. doi: 10.4103/jcvjs.jcvjs_74_23. Epub 2024 Mar 13.

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.

: 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.

PMID:38644921 | PMC:PMC11029118 | DOI:10.4103/jcvjs.jcvjs_74_23

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Management of lumbar spondylolisthesis: A retrospective analysis of posterior lumbar interbody fusion versus transforaminal lumbar interbody fusion

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J Craniovertebr Junction Spine. 2024 Jan-Mar;15(1):99-104. doi: 10.4103/jcvjs.jcvjs_74_23. Epub 2024 Mar 13. 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

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