Abstract:

This study aimed to evaluate the effects of transforaminal interbody fusion (TLIF) on the preservation or correction of regional lumbar alignment in patients with lumbosacral fusion surgery in compare with posterolateral intertransverse process fusion surgery (PLF). A total of 200 patients with severe low back pain and radicular pain were randomly selected for either posterolateral lumbar fusion by [titanium polyaxial pedicle screw] or transforaminal lumbar interbody fusion by [titanium polyaxial pedicle screw)] with intervertebral support by PEEK cage. The primary outcome scores were obtained using the visual analogue score (VAS) for Pain, Oswestry disability Index (ODI). All measures were assessed as follow-up after surgery. We included in this study 200 patients who fulfilled the inclusion criteria and underwent TLIF or PLF operation. The blood loss (250 cc) and duration of the procedure (2h) were better in PLF compared to TLIF (350cc; 2.5h) groups. However, the complications in PLF seem to be more sensitive to the presence of compiling chronic diseases (hypertension and diabetes mellitus). Analysis of pre- or post-operative follow-up parameters has indicated a non-significant difference between PLF and TLIF regarding all measured parameters except PRE-OP SS and POST OP LL which has shown a significant (P<0.05) higher in TLIF compared to PLF. Moreover, comparing results within the PLF group in PRE-OP versus POST-OP has shown significantly (P<0.05)  higher PRE-OP PT over POST-OP PT. Additionally, comparing results within the TLIF group in PRE-OP versus POST-OP has shown significantly (P<0.05)  higher POST-OP LL over PRE-OP LL alongside significantly (P<0.05)  higher PRE-OP PI-LL over POST-OP PI-LL. TLIF get higher improvement in lumbar parameters, especially lumbar lordosis, sacral slope, pelvic tilt and PI-LL mismatch. Improvement of local spinopelvic parameters (LL, SS and PT) contributes to improved post-operative functional scores (ODI and VAS).

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