Surgical treatment of lumbar spondylolisthesis by transforaminal lumbar interbody fusion
Kuang, L.; Xu, D.; Li, G.; Liu, C.; Wang, L.; Tian, J.
Zhonghua Yi Xue Za Zhi 94(29): 2293-2296
2014
ISSN/ISBN: 0376-2491 PMID: 25391875 Document Number: 675781
To explore the clinical outcomes of transforminal lumbar interbody fusion (TLIF) technique in treatment of lumbar spondylolisthesis. From June 2009 to June 2006, 42 patients underwent TLIF. There were 18 males and 24 females with an average age of 48 (30-68) years. The preoperative diagnoses included lumber degenerative spondylolisthesis (n = 16) and lumbar isthmic spondylolisthesis (n = 26). According to the Meyerding standard, 28 cases were classified as degreeI, 12 as degree II and 2 as degree III. Posterolateral fixation with pedicle screw and decompression, interbody fusion through TLIF technical plus cage for distraction reduction were employed. The evaluation standards of visual analog scale (VAS) and Oswestry disability index (ODI) were applied to evaluate the therapeutic outcomes.Intervertebral height and bone fusion were observed by radiology. All patients underwent surgery safely without any severe complication. The average follow-up period was 19.4 (9-36) months. Compared with preoperative parameters (7.07 ± 0.92), the postoperative scores of VAS decreased significantly (2.52 ± 1.37) and at the final follow-up (2.26 ± 1.61) (P < 0.05); compared with preoperative parameters (68.43 ± 12.81), the postoperative scores of ODI decreased significantly (24.19 ± 11.44) and at the final follow-up (20.86 ± 9.97) (P < 0.05) and no significant difference in VAS or ODI score existed between post-operation and last follow-up (P > 0.05). Compared with preoperative parameters (8.25 ± 1.27), the postoperative height of intervertebral space increased significantly (9.68 ± 1.62) and at the final follow-up (9.33 ± 1.25) (P < 0.05). And intervertebral height decreased at the final follow-up. There was significant difference between post-operation and last follow-up (P = 0.001). At the follow-up of 6.5 months postoperatively, all operated segments achieved fusion standard and no broken screw. There was 1 case of cage dislocation. TLIF may be performed easily and safely with fewer complications. And its efficacies are satisfactory for patients with lumbar spondylolisthesis.