Anterior/Posterior Lumbar Fusion Versus Transforaminal Lumbar Interbody Fusion: Analysis of Complications and Predictive Factors

Hee, Hwan Tak; Castro, Frank P.; Majd, Mohammad E.; Holt, Richard T.; Myers, Leann

doi:10.1097/00002517-200112000-00013

Cited by 174 publications

(113 citation statements)

References 18 publications

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“…In that study, 90% had solid fusions radiographically and 79% had excellent or good clinical outcomes. In our own previously reported study [19], we compared two techniques of circumferential fusion (anterior/posterior fusion versus transforaminal interbody and posterolateral fusion). TLIF is the preferred technique, because it is associated with a shorter operating time, less blood loss, shorter hospital stay, and lower incidence of complications.…”

Section: Discussionmentioning

confidence: 99%

“…The historical cohort was based on the authors' past operative experience [19]. For the purpose of this study, a sub-group of the historical cohort was used as the control group.…”

Section: Comparison With the Control Groupmentioning

confidence: 99%

“…The results were then compared to a historical control group without the use of AGF. This historical cohort was drawn from the authors' previous operative experience [19].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Do autologous growth factors enhance transforaminal lumbar interbody fusion?

Hee

Majd²,

Holt

et al. 2003

European Spine Journal

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149

101

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Section: Discussionmentioning

confidence: 99%

“…The historical cohort was based on the authors' past operative experience [19]. For the purpose of this study, a sub-group of the historical cohort was used as the control group.…”

Section: Comparison With the Control Groupmentioning

confidence: 99%

See 1 more Smart Citation

Do autologous growth factors enhance transforaminal lumbar interbody fusion?

Hee

Majd²,

Holt

et al. 2003

European Spine Journal

Self Cite

149

101

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“…Because of its posterolateral extracanalar discectomy and fusion, it has been reported as a safe technique, without the potential complications described when using combined APF and PLIF techniques [17,28]. Several authors have published retrospective studies comparing the TLIF technique to APF [16,18,35]. However, these studies included multiple diagnostic groups, and clinical as well as radiological outcomes were not always reported.…”

Section: Introductionmentioning

confidence: 99%

Clinical and radiological outcome of anterior–posterior fusion versus transforaminal lumbar interbody fusion for symptomatic disc degeneration: a retrospective comparative study of 133 patients

Faúndez¹,

Schwender

Safriel³

et al. 2009

Eur Spine J

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Abundant data are available for direct anterior/ posterior spine fusion (APF) and some for transforaminal lumbar interbody fusion (TLIF), but only few studies from one institution compares the two techniques. One-hundred and thirty-three patients were retrospectively analyzed, 68 having APF and 65 having TLIF. All patients had symptomatic disc degeneration of the lumbar spine. Only those with one or two-level surgeries were included. Clinical chart and radiologic reviews were done, fusion solidity assessed, and functional outcomes determined by pre-and postoperative SF-36 and postoperative Oswestry Disability Index (ODI), and a satisfaction questionnaire. The minimum follow-up was 24 months. The mean operating room time and hospital length of stay were less in the TLIF group. The blood loss was slightly less in the TLIF group (409 vs. 480 cc.). Intra-operative complications were higher in the APF group, mostly due to vein lacerations in the anterior retroperitoneal approach. Postoperative complications were higher in the TLIF group due to graft material extruding against the nerve root or wound drainage. The pseudarthrosis rate was statistically equal (APF 17.6% and TLIF 23.1%) and was higher than most published reports. Significant improvements were noted in both groups for the SF-36 questionnaires. The mean ODI scores at follow-up were 33.5 for the APF and 39.5 for the TLIF group. The patient satisfaction rate was equal for the two groups.

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“…This procedure diminishes neural retraction and reduces the risk of neural injury compared with bilateral posterior lumbar interbody fusion [8,12,28]. It is possible to perform unilateral posterior surgery using less invasive approaches to neural decompression and intervertebral arthrodesis through a tubular retractor and by augmenting the fusion construct with percutaneous pedicle screw instrumentation.…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Transforaminal Lumbar Interbody Fusion for Spondylolisthesis and Degenerative Spondylosis: 5-year Results

Park

Lee

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Multiple studies have reported favorable short-term results after treatment of spondylolisthesis and other degenerative lumbar diseases with minimally invasive transforaminal lumbar interbody fusion. However, to our knowledge, results at a minimum of 5 years have not been reported. Questions/purposes We determined (1) changes to the Oswestry Disability Index, (2) frequency of radiographic fusion, (3) complications and reoperations, and (4) the learning curve associated with minimally invasive transforaminal lumbar interbody fusion at minimum 5-year followup. Methods We reviewed our first 124 patients who underwent minimally invasive transforaminal lumbar interbody fusion to treat low-grade spondylolisthesis and degenerative lumbar diseases and did not need a major deformity correction. This represented 63% (124 of 198) of the transforaminal lumbar interbody fusion procedures we performed for those indications during the study period (2003)(2004)(2005)(2006)(2007). Eighty-three (67%) patients had complete 5-year followup. Plain radiographs and CT scans were evaluated by two reviewers. Trends of surgical time, blood loss, and hospital stay over time were examined by logarithmic curve fit-regression analysis to evaluate the learning curve. Results At 5 years, mean Oswestry Disability Index improved from 60 points preoperatively to 24 points and 79 of 83 patients (95%) had improvement of greater than 10 points. At 5 years, 67 of 83 (81%) achieved radiographic fusion, including 64 of 72 patients (89%) who had single-level surgery. Perioperative complications occurred in 11 of 124 patients (9%), and another surgical procedure was performed in eight of 124 patients (6.5%) involving the index level and seven of 124 patients (5.6%) at adjacent levels. There were slowly decreasing trends of surgical time and hospital stay only in single-level surgery and almost no change in intraoperative blood loss over time, suggesting a challenging learning curve. Conclusions Oswestry Disability Index scores improved for patients with spondylolisthesis and degenerative lumbar diseases treated with minimally invasive transforaminal lumbar interbody fusion at minimum 5-year followup. We suggest this procedure is reasonable for properly selected patients with these indications; however, traditional approaches should still be performed for patients with high-grade spondylolisthesis, patients with a severely collapsed disc space and no motion seen on the dynamic radiographs, patients who need multilevel decompression and arthrodesis, and patients with kyphoscoliosis needing correction.

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Anterior/Posterior Lumbar Fusion Versus Transforaminal Lumbar Interbody Fusion: Analysis of Complications and Predictive Factors

Cited by 174 publications

References 18 publications

Do autologous growth factors enhance transforaminal lumbar interbody fusion?

Do autologous growth factors enhance transforaminal lumbar interbody fusion?

Clinical and radiological outcome of anterior–posterior fusion versus transforaminal lumbar interbody fusion for symptomatic disc degeneration: a retrospective comparative study of 133 patients

Minimally Invasive Transforaminal Lumbar Interbody Fusion for Spondylolisthesis and Degenerative Spondylosis: 5-year Results

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