Abstract
Introduction
The first lumbar spinal fusion was introduced over 70 years ago and techniques have been evolving since then. Two popular techniques are Transforaminal Lumbar Interbody Fusion (TLIF) and Posterior Lumbar Interbody Fusion (PLIF). However, it is still controversial which is better. The aim of this study was to compare the clinical and radiological outcomes of those techniques.
Material and Methods
We retrospectively reviewed our spinal unit database to identify the patients who underwent TLIF and PLIF over the last 1 year. A hundred and ten patients were identified (54 TLIF, 56 PLIF). Demographics, Visual analogue score for leg and back pain and SF36 scores were analyzed preoperatively, at six weeks, six months and twelve months postopertively. Two independent reviewers assessed the X-rays for fusion at twelve months postoperatively using the Brantigan-Steffee classification.
Results
With regards to the clinical outcomes, TLIF patients had significantly better outcomes at six weeks with lower visual analogue scores (VAS) and better SF36 scores. The difference between the two groups has significantly reduced after one year. Both TLIF and PLIF patients had excellent lumbar spine fusion on X-rays at one year with good interobserver reliability (Kappa = 0.95)
Conclusion
Both TLIF and PLIF are excellent techniques for lumbar spinal fusion. There are no significant differences in the clinical and radiological outcomes between the two techniques at one year.