Evaluation of the discal height gain and lumbar lordosis variation obtained by the techniques of transforaminal and posterior lumbar intersomatic fusion

Abstract

ObjectiveEvaluate the discal height and lumbar lordosis gains, comparatively, according to the two lumbar arthrodesis techniques, transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF), used in the treatment of spinal degenerative diseases.MethodsThe present study, retrospective, was done with 60 patients who underwent decompression and 1 level lumbar arthrodesis in the Hospital Santa Casa de Misericórdia de Vitória (HSCMV), between January 2010 and December 2015. The patients were divided in two groups of 30 each, according to the utilized intersomatic arthrodesis technique: TLIF or PLIF. All patients presented pathologies at the L4-L5 level. In this study, the discal height gain and lumbar lordosis variation were evaluated by analyzing spinal radiographies of the pre and post-operatory periods from patients of the two groups, measured by the software Surgimap®. In addition, the pain intensity in the post-operatory period was estimated by the Visual Analog Scale for Pain (VAS Pain).ResultsBoth techniques presented a gain in the discal height in the post-operatory. There was no statistically significant difference between the discal height variation obtained with the PLIF technique when compared to the TLIF technique (p = 0.139). In the same way, there was no statistically significant difference in the lumbar lordosis variation between the two studied groups (p = 0.184). By the EVA Pain analysis, there was no significant difference in the pain intensity in the post-operatory period between both arthrodesis surgeries.ConclusionThere is no difference in the discal height gain and lumbar lordosis variation, as well as in the pain intensity in the post-operatory periods, in patients who underwent 1 level intersomatic arthrodesis when comparing the PLIF and TLIF techniques.

Transforaminal Intersomatic Lumbar Arthrodesis: Comparison Between Autograft and Cage in Peek

“…However, the main disadvantage is the high cost of the devices, especially for patients from developing countries and regions. [22][23][24] In vertebral fusion surgery, the bone graft favors consolidation. Traditionally obtained from the iliac crest of the patient, it provides mineral architecture for bone growth guidance and osteogenic factors.…”

“…11,12 The autograft of the iliac crest is considered the gold standard for spinal surgery. 13 The osteoconductive and osteoinductive properties Martinelli et al 22 evaluated the disc height and lumbar lordosis comparing the TLIF and PLIF techniques in a retrospective study, concluding that both techniques showed benefits, with no significant difference when comparing them. In the present study, lumbar lordosis and pre-and postoperative disc height were compared.…”

Assessment of Functional Outcome Predictors in Patients Undergoing Lumbar Interbody Fusion Surgery: A Single-Centre Analysis

“…Yet, excessive nerve or dural sac retraction and disruption of muscle integrity can cause pain, numbness, and/or neurological deficits after the procedure. TLIF might injure soft tissues due to neuromuscular retraction as well, but it has the advantage of providing easy access to the posterior structures, directly and unilaterally, decreasing the surgical trauma of the nerve roots [ 1 , 8 ].…”