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CC BY-NC-ND 4.0 · Indian Journal of Neurotrauma 2021; 18(01): 51-58
DOI: 10.1055/s-0040-1718781
Research Article

Comparative Study between Transforaminal Lumbar Interbody Fusion and Posterolateral Fusion for Treatment of Spondylolisthesis: Clinical Outcomes and Spino-Pelvic Sagittal Balance Parameters

Majid Reza Farrokhi
1   Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
,
Keyvan Eghbal
2   Shiraz Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
,
Seyed Reza Mousavi
2   Shiraz Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
,
Mustafa Moumani
2   Shiraz Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
,
Khshayar Bazyari
2   Shiraz Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
,
Bipin chaurasia
3   Department of Neurosurgery, Neurosurgery Clinic, Birgunj, Nepal
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Abstract

Objective This retrospective study aims to compare the clinical and radiological outcomes of posterolateral fusion (PLF) with transforaminal lumbar interbody fusion (TLIF + PLF) for the treatment of patients with low-grade spondylolisthesis.

Methodology A total of 77 adult patients ≥18 years with low-grade spondylolisthesis, Meyerding grades I and II, were assigned into two groups: 36 patients treated with PLF and 41 patients treated with TLIF + PLF. The PLF group is composed of the patients that were operated with pedicle screw and the TLIF + PLF group is composed of the ones that were operated with fixation and TILF by autografting. Clinical evaluation was performed using the spino-pelvic sagittal balance, Numeric Rating Scale, Oswestry Disability Index, blood loss, operation times, and postoperative hospital stay of the PLF vs TLIF groups. The incidences of postoperative low back pain and radicular pain in the two groups were also recorded. Radiography was performed preoperatively and postoperatively to assess spino-pelvic parameters.

Results Significant restoration of spino-pelvic sagittal balance was observed in the TLIF group after surgery, and all spino-pelvic sagittal balance parameters showed significant improvement in the TLIF group after surgery, while in the PLF group, all spino-pelvic sagittal parameters had improved except the segmental angle lordosis (p = 0.316), which showed no significant difference after surgery in the PLF group. Postoperative pelvic incidence and pelvic tilt significantly improved in the TLIF group in comparison to PLF groups. Hence, TLIF can achieve better postoperative spino-pelvic sagittal balance parameters than PLF. There was no difference in the complication rates for each group. Both groups achieved significant improvement in postoperative clinical outcomes, and there was no significant difference in the incidence of postoperative low back pain or radicular pain between the two groups.

Conclusion Both surgical procedures PLF and TLIF were effective. PLF and TLIF can result in improved clinical and radiological outcomes for patients treated for low-grade spondylolisthesis. TLIF can achieve better restoration of spino-pelvic sagittal balance parameters than PLF alone.

Keywords

spondylolisthesis - transforaminal lumbar interbody fusion - posterolateral fusion - spino-pelvic sagittal balance - low back pain - clinical outcomes - radicular pain


Publication History

Article published online:
22 March 2021

© 2020. Neurotrauma Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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