Comparison between posterior lumbar interbody fusion and transforaminal lumbar interbody fusion in the management of lumbar spondylolisthesis

BACKGROUND: Lumbar spondylolisthesis is a relatively common cause of low back and lower extremity pain. The most common type, degenerative lumbar spondylolisthesis (DLS), is a disease that causes stenosis of the spinal canal. Two surgical methods of treatment are widely accepted, namely posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF). MATERIALS AND METHODS: Between 2015 and 2017, the findings of 333 consecutive DLS patients who underwent surgical decompression with instrumented fusion were analyzed in a prospective study at the Department of Neurosurgery University Hospital and Faculty of Medicine at Safarik University in Kosice. The PLIF and TLIF procedures were performed in 214 and 119 patients, respectively. The clinical results and quality of life were compared. RESULTS: In comparison with PLIF, the TLIF procedures show better results as to the mean time of surgery (118.61 +/- 24.74 vs 147.56 +/- 38.62 min), blood loss (271.74 +/- 104.45 vs 361.23 +/- 142.78ml) and number of blood transfusions (6 vs 38); p=0.015, p=0.023, and p=0.001, respectively. PLIF and TLIF groups were compared as to the number of cases with nerve root injuries (14 vs 2), dural tear (17 vs 3), wound infections (8 vs 3) and reoperations (15 vs 2); p=0.04, p=0.04, p=0.55 and p=0.03, respectively. The quality of life at follow-up examinations significantly improved as measured with VAS and ODI (p=0.001). CONCLUSION: This research found that both surgical techniques, TLIF and PLIF, are suitable for DLS treatment. The two methods differed in postoperative complications which were less frequent in TLIF. There were no significant differences in the postoperative quality of life (Tab. 5, Ref. 19). Text in PDF www.elis.sk.