Sublaminar decompression and fusion versus transforaminal lumbar interbody fusion in management of lumbar degenerative disorders: a retrospective cohort study

2020 ◽  
Vol 31 (5) ◽  
pp. 448-456
Author(s):  
Mohammed Khalid Saleh ◽  
Tarek A. Elhewala
2020 ◽  
Author(s):  
Junchao Xing ◽  
Peng Cheng ◽  
Jianzhong Xu ◽  
Hongwei Lu ◽  
Qingyi He

Abstract Background This retrospective cohort study was conducted to compare the clinical efficacy and decompression parameters of extreme lateral lumbar interbody fusion (XLIF) with transforaminal lumbar interbody fusion (TLIF) in treating lumbar spinal stenosis (LSS). Methods From January 2012 to June 2016, 1455 patients with LSS who underwent surgery were reviewed and 83 cases were included (40 cases for XLIF and 43 cases for TLIF). The operative time, blood loss, accumulated fluoroscopy time, visual analogue scale (VAS), Oswestry Disability Index (ODI), fusion rate and complications were evaluated. Moreover, decompression parameters were compared, including the sagittal disc height (DH), the foraminal height (FH) and area (FA), the lumbar lordosis (LL), the transverse area of the dural sac (DS), as well as the rate of change loss of these parameters. Results The baseline was consistent between two groups. The mean follow-up time was 36.9 months. Both of XLIF and TLIF yielded clinical improvements. XLIF had advantages over TLIF in blood loss, operative time, hospital stay and complication. The fusion rate, postoperative VAS and ODI scores were comparable. Particularly, XLIF showed analogous, or even better, capacity of ameliorating decompression parameters to TLIF, especially regarding DH, LL and the maintenance of decompression. Conclusions Compared with TLIF, XLIF is advantageous to avoid blood loss, shorten the operative time, hospital stay and maintain the decompressive effect in treating LSS.


2021 ◽  
Vol 8 (21) ◽  
pp. 1647-1652
Author(s):  
Abhishek Komalsing Jaroli ◽  
Gajanand Dhaked ◽  
Harish Narayansingh Rajpurohit

BACKGROUND Operative treatment and fusion for isthmic spondylolisthesis can be achieved by various fusion techniques such as posterolateral fusion (PLF), anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF) and circumferential fusion. The purpose of this study is to evaluate the clinical outcome and radiological correction achieved after TLIF and assess the correlation between them if any. METHODS This is a retrospective cohort study analysing 30 cases of adult isthmic spondylolisthesis who failed conservative treatment and were then treated with transforaminal lumbar interbody fusion between 2011 and 2013. The clinical follow-up was done with the modified Oswestry disability index (ODI) and visual pain analogue score (VPAS). For the radiological follow-up radiographs were taken and several radiographic parameters were noted and analysed. RESULTS The mean of the Oswestry disability index scores in all patients decreased from 67.73 to 13.1 at final follow up. Similarly, visual pain analogue score reduced from mean 8.43 to 1.76 at final follow up. The average anterolisthesis was significantly reduced from the preoperative 27.1 ± 14 % to 7.1 ± 5 % at final follow-up radiographs (P < 0.001). Segmental lordosis increased from a mean of 11.5 degrees to 15.7 degrees. The difference in slip angle was significant from preoperative -4.87 ± 4.8 degrees and - 7.23 ± 4.63 degrees on the initial postoperative and - 7.2 ± 4.57 degrees at final follow-up radiographs (P = 0.14 and 0.13 respectively). CONCLUSIONS Thus, adult isthmic spondylolisthesis can be safely and effectively treated by TLIF with significant clinical relief and decrease in disability. TLIF procedure in isthmic spondylolisthesis is capable of reducing the sagittal translation and restoring disc height. Also, sagittal alignment and lordosis can be restored to a large extent. KEYWORDS Spondylolisthesis, Pelvic Incidence, Sagittal Balance, TLIF


2015 ◽  
Vol 55 (7) ◽  
pp. 547-556 ◽  
Author(s):  
Masahito HARA ◽  
Yusuke NISHIMURA ◽  
Yasuhiro NAKAJIMA ◽  
Daisuke UMEBAYASHI ◽  
Masaya TAKEMOTO ◽  
...  

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