Perioperative Comparison of Transforaminal Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion Using Cages for Treatment of Degenerative Lumbar Disorders

Objectives: Surgical fusion of the lumbar spine is an important method for the permanent stabilization after decompression surgery. Various clinical modalities of spinal fusion have been reported. Both transforaminal interbody fusion (TLIF) and posterior interbody fusion (PLIF) provide a circumferential fusion and are considered reasonable surgical options. The purpose of this study was to quantitatively assess clinical parameters such as surgical blood loss, duration of the procedure and hospitalization and complications for TLIF and PLIF for lumbar fusion.
Methods: Fifty-two patients with degenerative lumbar disorders treated with posterior decompression, posterior pedicle screws instrumentation and transforaminal lumbar interbody fusion (TLIF) or posterior lumbar interbody fusion (PLIF) with cages for one-or two-level degenerative lumbar disorders were analyzed retrospectively. Perioperative data including patient's basic data, operation time, blood loss, hospitalization days and complications were compared between these two groups.
Results: The mean operation time and blood loss of the TLIF group were less than those of the PLIF group. The difference in the average length of hospitalization was not statistically significant. No major complication was observed during the operations or at follow-up in both groups. There were two patients with transient neurologic deficit in the TLIF group and one patient in the PLIF group.
Conclusions: Considering diminished blood loss, shortened operation time and relatively safely procedure, TLIF is considered as a more advantageous method than PLIF when been used for fusion in the treatment of degenerative lumbar disorders.