A retrospective comparison of radiographic and clinical outcomes in single-level degenerative lumbar disease undergoing anterior versus transforaminal lumbar interbody fusion
BACKGROUNDSingle-level lumbar degenerative disc disease (DDD) remains a significant cause of morbidity in adulthood. Anterior lumbar interbody fusion (ALIF) and Transforaminal lumbar interbody fusion (TLIF) are surgical techniques developed to treat this condition. With limited studies on intermedia...
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Published in | Journal of spine surgery (Hong Kong) Vol. 7; no. 2; pp. 170 - 180 |
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Main Authors | , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
AME Publishing Company
01.06.2021
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Subjects | |
Online Access | Get full text |
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Summary: | BACKGROUNDSingle-level lumbar degenerative disc disease (DDD) remains a significant cause of morbidity in adulthood. Anterior lumbar interbody fusion (ALIF) and Transforaminal lumbar interbody fusion (TLIF) are surgical techniques developed to treat this condition. With limited studies on intermediate term outcomes in a single cohort, we compare radiographic and clinical outcomes in patients undergoing ALIF and TLIF. METHODSA retrospective chart review was performed on 164 patients (111 TLIF; 53 ALIF) over a 60-month period. X-ray radiographs obtained pre-operatively, prior to discharge, and at one year were utilized for radiographic assessment. Segmental lordosis, lumbar lordosis and HRQOL scores were measured preoperatively and at one-year timepoints. RESULTSChanges in lumbar lordosis and segmental lordosis were significantly greater after ALIF (4.6° vs. -0.6°, P=0.05; 4.7° vs. -0.7°, P<0.05) at one year (mean time, 366±20 days). At one year or greater, there was a greater reduction in mean VAS-leg score in TLIF patients (3.4 vs. 0.6, P<0.05) and ODI score (16.2 vs. 5.4, P<0.05). Similar outcomes were seen for VAS-back, SF-12 Physical Health, and SRS-30 Function/Activity. SF-12 Mental Health scores were found to be lower in patients undergoing TLIF (-3.5 vs. 2.7, P<0.05). CONCLUSIONSALIF demonstrated a superior method of increasing lumbar and segmental lordosis. TLIF was utilized more in patients with higher pre-operative VAS-leg pain scores and therefore, showed a greater magnitude of VAS-leg pain improvement. TLIF also demonstrated a greater improvement in ODI scores despite similar baseline scores, suggesting a possible enhanced functional outcome. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Contributions: (I) Conception and design: ZB Moses, S Razvi, C Witiw, BT David, RG Fessler; (II) Administrative support: RBV Fontes, H Deutsch, JE O’Toole, RG Fessler; (III) Provision of study materials or patients: RBV Fontes, H Deutsch, JE O’Toole, RG Fessler; (IV) Collection and assembly of data: ZB Moses, S Razvi, SY Oh, A Platt, KC Keegan, F Hamati, C Witiw; (V) Data analysis and interpretation: ZB Moses, SY Oh, RBV Fontes, H Deutsch, JE O’Toole, RG Fessler; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. |
ISSN: | 2414-469X 2414-4630 |
DOI: | 10.21037/jss-20-673 |