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Posterolateral vs transforaminal interbody L4/5 fusion: Correlation with subsequent surgery

Journal of Spinal Disorders & Techniques Mar 08, 2019

Gaffney CJ, et al. - In this retrospective cohort study, investigators examined the rates of subsequent surgery, clinical and radiographic parameters, and patient satisfaction in posterolateral vs transforaminal interbody fusion (PLF vs PLF+TLIF) of the L4/5 segment among 89 candidates, from January 2006 to 2012. They measured preoperative and postoperative patient-reported outcomes via Oswestry disability index, visual analog scale back pain, visual analog scale leg pain, and radiographic parameters ie, L4/5 lordosis and overall lumbar lordosis. They observed subsequent lumbar surgery in 2 of 31 patients in the PLF group and 16 of 58 patients in the PLF+TLIF group (6% vs 28%) at an average of 8.7 years follow-up. They considered PLF and PLF+TLIF both, efficient fusion methods for L4/5 stenosis and spondylolisthesis. They noted less prevalence of undergoing subsequent lumbar surgery among subjects treated with PLF.
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