scholarly journals Outcomes of Extended Transforaminal Lumbar Interbody Fusion for Lumbar Spondylosis: A Retrospective Cohort Study

2015 ◽  
Vol 03 (01) ◽  
Author(s):  
Adrian J Talia Michael L Wong
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Lumbar Spondylosis

scholarly journals Quantitative comparison of clinical outcomes and decompression parameters between extreme lateral lumbar interbody fusion and transforaminal lumbar interbody fusion in treating lumbar spinal stenosis: a 3-year retrospective cohort study

2020 ◽  
Author(s):  
Junchao Xing ◽  
Peng Cheng ◽  
Jianzhong Xu ◽  
Hongwei Lu ◽  
Qingyi He
Keyword(s):  
Cohort Study ◽  
Blood Loss ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Interbody Fusion ◽  
Operative Time ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Lumbar Interbody Fusion ◽  
Lumbar Spinal

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.

scholarly journals Clinical and Radiological Outcomes in Patients of Isthmic Spondylolisthesis Treated with Transforaminal Lumbar Interbody Fusion - A Retrospective Cohort Study, New Delhi

2021 ◽  
Vol 8 (21) ◽  
pp. 1647-1652
Author(s):  
Abhishek Komalsing Jaroli ◽  
Gajanand Dhaked ◽  
Harish Narayansingh Rajpurohit
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Oswestry Disability Index ◽  
Retrospective Cohort ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Isthmic Spondylolisthesis ◽  
Circumferential Fusion

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

Increased incidence of pseudarthrosis after unilateral instrumented transforaminal lumbar interbody fusion in patients with lumbar spondylosis

2014 ◽  
Vol 21 (4) ◽  
pp. 601-607 ◽  
Author(s):  
Yakov Gologorsky ◽  
Branko Skovrlj ◽  
Jeremy Steinberger ◽  
Max Moore ◽  
Marc Arginteanu ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Interbody Fusion ◽  
Demographic Data ◽  
Wound Dehiscence ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Lumbar Spondylosis ◽  
Pedicle Screw Instrumentation ◽  
Estimated Blood Loss ◽  
Unilateral Pedicle Screw

Object Transforaminal lumbar interbody fusion (TLIF) with segmental pedicular instrumentation is a wellestablished procedure used to treat lumbar spondylosis with or without spondylolisthesis. Available biomechanical and clinical studies that compared unilateral and bilateral constructs have produced conflicting data regarding patient outcomes and hardware complications. Methods A prospective cohort study was undertaken by a group of neurosurgeons. They prospectively enrolled 80 patients into either bilateral or unilateral pedicle screw instrumentation groups (40 patients/group). Demographic data collected for each group included sex, age, body mass index, tobacco use, and Workers' Compensation/litigation status. Operative data included segments operated on, number of levels involved, estimated blood loss, length of hospital stay, and perioperative complications. Long-term outcomes (hardware malfunction, wound dehiscence, and pseudarthrosis) were recorded. For all patients, preoperative baseline and 6-month postoperative scores for Medical Outcomes 36-Item Short Form Health Survey (SF-36) outcomes were recorded. Results Patient follow-up times ranged from 37 to 63 months (mean 52 months). No patients were lost to follow-up. The patients who underwent unilateral pedicle screw instrumentation (unilateral cohort) were slightly younger than those who underwent bilateral pedicle screw instrumentation (bilateral cohort) (mean age 42 vs 47 years, respectively; p = 0.02). No other significant differences were detected between cohorts with regard to demographic data, mean number of lumbar levels operated on, or distribution of the levels operated on. Estimated blood loss was higher for patients in the bilateral cohort, but length of stay was similar for patients in both cohorts. The incidence of pseudarthrosis was significantly higher among patients in the unilateral cohort (7 patients [17.5%]) than among those in the bilateral cohort (1 patient [2.5%]) (p = 0.02). Wound dehiscence occurred for 1 patient in the unilateral cohort. Reoperation was offered to 8 patients in the unilateral cohort and 1 patient in the bilateral cohort (p = 0.03). The physical component scores of the Medical Outcomes SF-36 outcomes improved significantly for all patients (p < 0.001). Conclusions Transforaminal lumbar interbody fusion with either unilateral or bilateral segmental pedicular instrumentation is an effective treatment for lumbar spondylosis. Because patients with unilateral constructs were 7 times more likely to experience pseudarthrosis and require reoperation, TLIF with bilateral constructs might be the biomechanically superior technique.

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