Comparison between Posterior and Transforaminal Approaches for Lumbar Interbody Fusion.
- Author:
Jae Sung PARK
1
;
Young Baeg KIM
;
Hyun Jong HONG
;
Sung Nam HWANG
Author Information
1. Department of Neurosurgery, Chungang University College of Medicine, Seoul, Korea. ybkim1218@cau.ac.kr
- Publication Type:Original Article
- Keywords:
Lumbar fusion;
Posterior lumbar interbody fusion;
Transforaminal lumbar interbody fusion
- MeSH:
Hand;
Humans;
Length of Stay;
Retrospective Studies;
Spinal Stenosis;
Spine;
Zygapophyseal Joint
- From:Journal of Korean Neurosurgical Society
2005;37(5):340-344
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Posterior lumbar interbody fusion(PLIF), the current leading method of pedicle screw fixation combined with interbody fusion via posterior route, sometimes requires too much destruction of the facet joint than expected especially for the patient with a narrow spine. On the other hand, tranforaminal lumbar interbody fusion(TLIF) technique provides potential advantages over PLIF and can be chosen as a better surgical alternative to more traditional fusion methods in certain surgical conditions. METHODS: From October 1999, 99 PLIF and 29 TLIF procedures were done for the patients with spinal stenosis and instability. Radiological data including the interpedicular distance and the size of the pedicles as well as the clinical parameters were collected retrospectively. The degree of resection of the inferior articular process was compared with the interpedicular distance in each patient who received PLIF. RESULTS: No significant differences were found between PLIF and TLIF regarding the operation time, blood loss, duration of hospital stay, or short term postoperative clinical result. There were no complication with TLIF, but PLIF resulted in 9(9.1%) complications. During PLIF procedure, all patients(n=24) except one with the interpedicular distance shorter than 27mm required near complete or complete resection of the inferior articular processes, whereas only 6(31.5%) of 19 patients with the interpedicular distances longer than 30mm required the similar extent of resection. CONCLUSION: TLIF is better than PLIF in terms of the complication rate. The patient who had narrow interpedicular distance(<27mm) might be better candidate for TLIF.
