Kim DH, Hwang RW, Lee GH, et al. - A retrospective computed tomography (CT) based review was designed to ascertain the effect of transforaminal approach (TLIF) on early pedicle screw loosening and radiographic fusion rates compared to posterolateral fusion surgery (PLF) using pedicle screws alone in the treatment of single level lumbar degenerative conditions. Researchers included a total of 193 patients who had undergone TLIF+PLF with local autograft bone or PLF alone with local autograft bone. They assessed radiographic fusion rates and screw loosening at 6-months and 12-months using strict CT criteria. They analyzed postoperative thin-cut CTs for pedicle screw loosening and radiographic fusion status. Six-month postoperative CT was applied to ascertain early screw loosening rates, while radiographic fusion rates were ascertained using 12-month postoperative CT. Using one-way analysis of variance, significant differences in mean outcome scores and other continuous measures between groups at baseline and follow-up were ascertained. Proportions between groups on categorical measures were compared using Chi-square test of independence or Fisher's exact test. The data show that TLIF seems to have a protective impact, decreasing rates of early screw loosening by approximately 60% versus PLF. Nevertheless, at 12 months, this impact appears independent of actual overall radiographic fusion rates which may be approximately 20% lower with TLIF. The results considered that TLIF may have advantages in patients where early loosening is a particular concern, for example, in the setting of increased patient age.