Transforaminal versus posterior lumbar interbody fusion as operative treatment of lumbar spondylolisthesis, a retrospective case series

Kunder, S. L. de; Rijkers, Kim; Hemert, Wouter L.W. van; Willems, Paul; Poort, M. P. ter Laak; Santbrink, Henk van

doi:10.1016/j.inat.2016.07.001

Cited by 14 publications

(25 citation statements)

References 15 publications

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“…Even though these techniques are assumed to be equal, nonrandomized studies and one small RCT comparing TLIF and PLIF suggest that TLIF is associated with fewer complications, less blood loss, shorter surgical time and hospital duration [ 8 – 10 ]. Our own retrospective data of 254 TLIF and PLIF patients confirm this, and additionally reveal that TLIF patients score better on different quality of life related outcome parameters (SF-36, ODI) compared to PLIF [ 11 ]. These findings have not been confirmed in a randomized controlled trial.…”

Section: Introductionsupporting

confidence: 57%

A protocol of a randomized controlled multicenter trial for surgical treatment of lumbar spondylolisthesis: the Lumbar Interbody Fusion Trial (LIFT)

Kunder

Rijkers

Kuijk

et al. 2016

BMC Musculoskelet Disord

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BackgroundWith a steep increase in the number of instrumented spinal fusion procedures, there is a need for comparative data to develop evidence based treatment recommendations. Currently, the available data on cost and clinical effectiveness of the two most frequently performed surgeries for lumbar spondylolisthesis, transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF), are not sufficient. Therefore, current guidelines do not advise which is the most appropriate surgical treatment strategy for these patients. Non-randomized studies comparing TLIF and PLIF moreover suggest that TLIF is associated with fewer complications, less blood loss, shorter surgical time and hospital duration. TLIF may therefore be more cost-effective. The results of this study will provide knowledge on short- and long-term clinical and economical effects of TLIF and PLIF procedures, which will lead to recommendations for treating patients with lumbar spondylolisthesis.MethodsMulticenter blinded Randomized Controlled Trial (RCT; blinding for the patient and statistician, not for the clinician and researcher). A total of 144 patients over 18 years old with symptomatic single level lumbar degenerative, isthmic or iatrogenic spondylolisthesis whom are candidates for LIF (lumbar interbody fusion) surgery through a posterior approach will be randomly allocated to TLIF or PLIF. The study will consist of three parts: 1) a clinical effectiveness study, 2) a cost-effectiveness study, and 3) a process evaluation.The primary clinical outcome measures are: change in disability measured with Oswestry Disability Index (ODI) and change in quality adjusted life years (QALY) measured with EQ-5D-5L. Secondary clinical outcome measures are: Short Form (36) Health Survey (SF-36), VAS back pain, VAS leg pain, Hospital Anxiety Depression Scale (HADS), complications, productivity related costs (iPCQ) and medical costs (iMCQ). Measurements will be carried out at five fixed time points (pre-operatively and at 3, 6, 12 and 24 months).DiscussionIt is hypothesized that TLIF, compared to PLIF, has similar clinical outcome or is possibly better in reducing disability. Moreover, direct medical costs are expected to be lower due to less surgical morbidity, shorter hospital stay and shorter surgical time. Indirect costs are assumed to be lower for TLIF as well, because we suspect less working days are lost. Currently, prospective data comparing clinical and cost-effectiveness of both techniques are not available. Therefore, in clinical practice both techniques are used and the choice for technique is greatly based on surgeon’s preference. The demand for spinal fusion surgery has risen steeply over the last 10 years and is expected to increase even further in the near future. As a result, the burden on society (and the working population) will increase. In case our hypothesis is confirmed, treatment guidelines will be adapted, and TLIF will be recommended as first choice surgical treatment of lumbar spondylolisthesis. Ultimately this wi...

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Section: Introductionsupporting

confidence: 57%

A protocol of a randomized controlled multicenter trial for surgical treatment of lumbar spondylolisthesis: the Lumbar Interbody Fusion Trial (LIFT)

Kunder

Rijkers

Kuijk

et al. 2016

BMC Musculoskelet Disord

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“…Many systematic reviews, meta-analysis, prospective, and retrospective studies were conducted in an attempt to compare the clinical and radiographic outcomes of TLIF and PLIF for the treatment of spondylolisthesis [3], [10], [11], [12], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27]. Unfortunately, there was no study comparing them in terms of their costs.…”

Section: Discussionmentioning

confidence: 99%

“…In terms of complications, nerve root injury occurred in 6.7% of the PLIF patients versus none in the TLIF group. In our literature review, this rate was 0-13.6% in the PLIF patients and 0-5.6% in the TLIF patients [10], [11], [14], [16], [17], [18], [19], [21], [22], [23], [24], [25], [26], [27]. About 6.7% of each group of this study developed intraoperative dural tear which is a similar rate to that was reported in the literature from higher-income nations which range from 0% to 23.1% of the PLIF patients and from 0 to 10.4% of the TLIF patients [10], [11], [14], [15], [16], [17], [18], [19], [22], [23], [24], [26], [27].…”

Section: Complicationsmentioning

confidence: 99%

A Prospective Randomized Study of the Safety and Efficacy of Transforaminal Lumbar Interbody Fusion Versus Posterior Lumbar Interbody Fusion in the Treatment of Lumbar Spondylolisthesis: A Cost utility from a Lower-middle-income Country Perspective and Review of Literature

El-Ghandour

Sawan

Goel

et al. 2021

Open Access Maced J Med Sci

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BACKGROUND: The safety and efficacy of transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF) in lumbar spondylolisthesis have not been validated in many prospective randomized trials. AIM: We aimed to validate the safety and efficacy of TLIF and PLIF surgery in lumbar spondylolisthesis using the clinical, radiographic, and cost-utility outcomes. METHODS: The data of surgically treated single-level spondylolisthesis patients were randomized prospectively into two groups. The groups were compared regarding demographics, perioperative complications, hospital stay, total expenditure, fusion rate, and clinical outcomes (visual analog scale, Oswestry disability index, Zurich claudication scale, and Odom’s criteria). A review of literature was done to compare the outcomes with the ones from higher-income nations. RESULTS: Thirty-three patients underwent prospective randomization. The improvement in the clinical outcomes at 12-month follow-up showed improvement in the TLIF group more than the PLIF group but with no significant difference. The mean operative time was significantly longer in the PLIF (p < 0.05), also, the blood loss was significantly less in the TLIF (p < 0.001). The complications frequency did not show any statistical significance between both groups and no significant difference in the patient’s post-operative patient satisfaction (p = 0.6). The mean hospital stay was non-significantly longer in the PLIF (p = 0.7). At 12-month follow-up, 93.3% of the TLIF patients were fused versus 86.7% of the PLIF (p = 0.5). The total cost of the TLIF was significantly less (p < 0.001). CONCLUSION: Both PLIF and TLIF could achieve similar fusion rates and clinical satisfaction in the management of lumbar spondylolisthesis. The TLIF group was significantly better in terms of financial burden, operative time, and blood loss.

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“…These have contributed to a reduction in the operation risks, operation time, and blood loss during PLIF. [ 37 ] During a PLF procedure, the broad dissection that exceeds the facet joint may lead to a transiently aggravated postoperative pain, which can further influence patient satisfaction on the procedure. Specifically, PLIF can overcome these drawbacks and provide anterior column support, which helps to restore lumbar lordosis, intervertebral space height, and increase fusion rate.…”

Section: Discussionmentioning

confidence: 99%

A Bayesian network meta-analysis of 5 different fusion surgical procedures for the treatment of lumbar spondylolisthesis

Tang¹,

Wu²,

Jing³

et al. 2020

Medicine

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Transforaminal versus posterior lumbar interbody fusion as operative treatment of lumbar spondylolisthesis, a retrospective case series

Cited by 14 publications

References 15 publications

A protocol of a randomized controlled multicenter trial for surgical treatment of lumbar spondylolisthesis: the Lumbar Interbody Fusion Trial (LIFT)

A protocol of a randomized controlled multicenter trial for surgical treatment of lumbar spondylolisthesis: the Lumbar Interbody Fusion Trial (LIFT)

A Prospective Randomized Study of the Safety and Efficacy of Transforaminal Lumbar Interbody Fusion Versus Posterior Lumbar Interbody Fusion in the Treatment of Lumbar Spondylolisthesis: A Cost utility from a Lower-middle-income Country Perspective and Review of Literature

A Bayesian network meta-analysis of 5 different fusion surgical procedures for the treatment of lumbar spondylolisthesis

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