OUTCOMES OF TRANSFORAMINAL LUMBAR INTERBODY FUSION AND POSTERIOR LUMBAR INTERBODY FUSION IN MANAGING SINGLE-LEVEL LUMBAR SPONDYLOLISTHESIS

Authors

  • Haider Ali Khattak Department of Neurosurgery, Ayub Medical College, Abbottabad-Pakistan
  • Nasim Gul Department of Neurosurgery, Zayed Military Hospital, Abu Dhabi-UAE
  • Adnan Khaliq Department of Neurosurgery, Swat Medical College, Swat-Pakistan
  • Mian Iftikhar ul Haq Department of Neurosurgery, Hayatabad Medical Complex, Peshawar-Pakistan
  • Shahid Nawaz Department of Neurosurgery, Gomal Medical College, DI Khan-Pakistan
  • Shahbaz Ali Khan Department of Neurosurgery, Ayub Medical College, Abbottabad-Pakistan

Keywords:

Posterior lumbar interbody fusion (PLIF), Transforaminal lumbar interbody fusion (TLIF), Spondylolisthe

Abstract

Background: There is significant discussion over the most effective surgical approach for treating lumbar spondylolisthesis, despite the recommendation of a number of surgical approaches. The aim of this study was to explore the Outcomes of transforaminal lumbar interbody fusion and posterior lumbar interbody fusion in managing single-level lumbar spondylolisthesis. Methods: The current study was conducted at the department of orthopedic and neurosurgery from January 2022 to February 2023 after taking approval from the ethical committee of the institute. Those individuals who had experienced a single-level condition with a low-grade categorization (grades I or II) in the Meyerding grading system were included in the study. A total of 52 patients were enrolled in this study and were divided in to group A and B. 26 received PLIF, and were placed in group A while 26 had done TLIF and were placed in group B. The two groups' mean operating times, blood loss, VAS scores for back and leg discomfort, and complications were compared. SPSS 24 was used for data analysis. While frequency and percentages were used to analyze categorical data, mean and standard deviation were used for analyzing numerical statistics. To compare numerical values between the two groups, the Independent Samples T-test was used, with the p value significant at < 0.05. Results: A total of 52 individuals were enrolled in this investigation, distributed evenly into two groups. The mean age of the participants was 35.14±7.76 years. Out of 52 patients male were 30(57.6% and 22(42.30) were females. Patients in group B underwent TLIF while patients in group A got PLIF. With respect to the results for the two groups, individuals in the group A had mean operative time 126.44±12.03 minutes and Group B had a considerably shorter duration of 113.32±8.48 minutes (P < 0.05). In group A, the average blood loss was 440±76.33 cm3 but Group B experienced a much lower value of 371.40±39.2 cm³ (P < 0.05). Concerning postoperative VAS leg pain, there was no difference between the two groups (P > 0.05) while group B experienced considerably less postoperative pain in the back on the VAS than group A did (P < 0.05). Dural tear was noted in 4 participants in group A, while 2 in group B. 3 patients in group A experienced a neurologic impairment, but in group b there was no neurologic deficit noted. 3 individuals in group A experienced wound infections, whereas none of the patients in group B did.
Conclusion: Based on our research, TLIF is better than PLIF in terms of functional result and rate of complications in patients with grade I/II single-level lumbar spondylolisthesis.

References

1. Lastfogel JF, Altstadt TJ, Rodgers RB, Horn EM. Sacral fractures following stand-alone L5-S1 anterior lumbar interbody fusion for isthmic spondylolisthesis. J Neurosurg Spine. 2010; 13:288–93.

2. Butt MF, Dhar SA, Hakeem I, Farooq M, Halwai MA, Mir MR, Kangu KA. In situ instrumented posterolateral fusion without decompression in symptomatic low-grade isthmic spondylolisthesis in adults. Int Orthop. 2008; 32:663–9.

3. Sivaraman A, Altaf F, Jalgaonkar A, Kakkar R, Sirigiri PB, Howieson A, Crawford RJ. Prospective study of posterior lumbar interbody fusion with either interbody graft or interbody cage in the treatment of degenerative spondylolisthesis. J Spinal Disord Tech. 2015; 28:E467–71.

4. Ha KY, Na KH, Shin JH, Kim KW. Comparison of posterolateral fusion with and without additional posterior lumbar interbody fusion for degenerative lumbar spondylolisthesis. J Spinal Disord Tech. 2008; 21:229–34.

5. Noggle JC, Sciubba DM, Samdani AF, Anderson DG, Betz RR, Asghar J.Minimally invasive direct repair of lumbar spondylolysis with a pedicle screw and hook construct. Neurosurg Focus. 2008; 25:E15.

6. Harms J, Rolinger H. A one-stager procedure in operative treatment of spondylolistheses: dorsal traction-reposition and anterior fusion (author’s transl). Z Orthop Ihre Grenzgeb. 1982; 120:343–7.

7. De Kunder, SL., van Kuijk, SM., Rijkers, K., Caelers, IJ., van Hemert, WL., de Bie, R.A., and van Santbrink, H. (2017). Transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) in lumbar spondylolisthesis: a systematic review and metaanalysis. The spine journal 17, 1712-1721.

8. Qureshi, R., Puvanesarajah, V., Jain, A., Shimer, A. L., Shen, F. H., and Hassanzadeh, H. (2017). A comparison of anterior and posterior lumbar interbody fusions. Spine 42, 1865-1870

9. Agabegi, S. S., and Fischgrund, J. S. (2010). Contemporary management of isthmic spondylolisthesis: pediatric and adult. The Spine Journal 10, 530-543.

10. Wu, C.-H., Wong, C.-B., Chen, L.-H., Niu, C.-C., Tsai, T.-T., and Chen, W.-J. (2008). Instrumented posterior lumbar interbody fusion for patients with degenerative lumbar scoliosis. Clinical ine Surgery 21, 310-315

11. Spruit, M., Pavlov, P., Leitao, J., De Kleuver, M., Anderson, P., and Den Boer, F. (2002). Posterior reduction and anterior lumbar interbody fusion in symptomatic low-grade adult isthmic spondylolisthesis: short-term radiological and functional outcome. European Spine Journal 11, 428-433

12. Videbaek, T. S., Christensen, F. B., Soegaard, R., Hansen, E. S., Høy, K., Helmig, P., Niedermann, B., Eiskjœr, S. P., and Bünger, C. E. (2006). circumferential fusion improves outcome in comparison with instrumented posterolateral fusion: long-term results of a randomized clinical trial. LWW.

13. Kwon, B. K., Hilibrand, A. S., Malloy, K., Savas, P. E., Silva, MT., Albert, T. J., and Vaccaro, A. R. (2005). A critical analysis of the literature regarding surgical approach and outcome for adult low-grade isthmic spondylolisthesis. Clinical Spine Surgery 18, S30-S40.

14. STONECIPHER, T., and WRIGHT, S. (1989). Posterior lumbar interbody fusion with facet-screw fixation. Spine 14, 468-471

15. Rezk, E. M. A., Elkholy, A. R., and Shamhoot, E. A. (2019). Transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) in the treatment of single-level lumbar spondylolisthesis. Egyptian Journal of Neurosurgery 34, 1-8.

16. Liu, J., Deng, H., Long, X., Chen, X., Xu, R., and Liu, Z. (2016). A comparative study of perioperative complications between transforaminal versus posterior lumbar interbody fusion in degenerative lumbar spondylolisthesis. European Spine Journal 25, 1575-1580.

Published

2024-12-29

How to Cite

Khattak, H. A., Nasim Gul, Adnan Khaliq, Mian Iftikhar ul Haq, Shahid Nawaz, & Khan, S. A. (2024). OUTCOMES OF TRANSFORAMINAL LUMBAR INTERBODY FUSION AND POSTERIOR LUMBAR INTERBODY FUSION IN MANAGING SINGLE-LEVEL LUMBAR SPONDYLOLISTHESIS. Journal of Ayub Medical College Abbottabad, 36(4). Retrieved from https://jamc.ayubmed.edu.pk/index.php/jamc/article/view/13192