Anterior Versus Transforaminal Lumbar Interbody Fusion: Perioperative Risk Factors and 30-Day Outcomes

Upadhyayula, Pavan S.; Curtis, Erik; Yue, John K.; Sidhu, Nikki; Ciacci, Joseph D.

doi:10.14444/5065

Cited by 27 publications

(34 citation statements)

References 39 publications

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“…Another study found that ALIF patients had a higher reoperation rate within 2 years and a higher complication rate, in comparison with a TLIF group [23]. ALIF patients were also found to have shorter surgery times and lower rates of urinary tract infection but more pulmonary complications and longer hospital stays than TLIF patients [73]. However, although studies have shown ALIF to provide better disc and foraminal height, as well as restoration of lordosis, no studies have shown a difference in fusion rates between ALIF and posterior interbody approaches [14, 17, 30].…”

Section: Resultsmentioning

confidence: 99%

Interbody Fusions in the Lumbar Spine: A Review

Verma

Virk

Qureshi

2020

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background Lumbar interbody fusion is among the most common types of spinal surgery performed. Over time, the term has evolved to encompass a number of different approaches to the intervertebral space, as well as differing implant materials. Questions remain over which approaches and materials are best for achieving fusion and restoring disc height. Questions/Purposes We reviewed the literature on the advantages and disadvantages of various methods and devices used to achieve and augment fusion between the disc spaces in the lumbar spine. Methods Using search terms specific to lumbar interbody fusion, we searched PubMed and Google Scholar and identified 4993 articles. We excluded those that did not report clinical outcomes, involved cervical interbody devices, were animal studies, or were not in English. After exclusions, 68 articles were included for review. Results Posterior approaches have advantages, such as providing 360° support through a single incision, but can result in retraction injury and do not always restore lordosis or correct deformity. Anterior approaches allow for the largest implants and good correction of deformities but can result in vascular, urinary, psoas muscle, or lumbar plexus injury and may require a second posterior procedure to supplement fixation. Titanium cages produce improved osteointegration and fusion rates but also increase subsidence caused by the stiffness of titanium relative to bone. Polyetheretherketone (PEEK) has an elasticity closer to that of bone and shows less subsidence than titanium cages, but as an inert compound PEEK results in lower fusion rates and greater osteolysis. Combination PEEK–titanium coating has not yet achieved better results. Expandable cages were developed to increase disc height and restore lumbar lordosis, but the data on their effectiveness have been inconclusive. Three-dimensionally (3D)-printed cages have shown promise in biomechanical and animal studies at increasing fusion rates and reducing subsidence, but additive manufacturing options are still in their infancy and require more investigation. Conclusions All of the approaches to spinal fusion have plusses and minuses that must be considered when determining which to use, and newer-technology implants, such as PEEK with titanium coating, expandable, and 3D-printed cages, have tried to improve upon the limitations of existing grafts but require further study.

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Section: Resultsmentioning

confidence: 99%

Interbody Fusions in the Lumbar Spine: A Review

Verma

Virk

Qureshi

2020

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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“…Advantages of TLIF over PLIF include better improvement in lumbar lordosis by placement of interbody graft within the anterior column, greater enlargement of the neural foramen, and the option for using an effective unilateral approach; it provides a surgical reservoir for the other aspects of the posterior column integrity, such as the contralateral lamina, facet, and pars, which provide a greater fusion bed for posterior and posterolateral bony arthrodesis. To date, minimally invasive (MIS) lumbar fusion is being increasingly performed, with the clear advantages in the tissue disruption and patient morbidity [ 4 , 5 , 6 ]. Similarly, MIS-TLIF has been shown to have decreased operative time, intraoperative blood loss, incidence of perioperative infection, and decreased overall hospital stay and earlier return to daily living compared to open TLIF.…”

Section: Discussionmentioning

confidence: 99%

“…Interbody procedures with cage insertion are essential for lumbar fusion surgery, and techniques for interbody procedure have advanced over time [ 2 , 3 , 4 , 5 ]. Conventionally, cage insertion via the transforaminal route after a posterior approach (transforaminal lumbar interbody fusion, TLIF) has been the gold-standard procedure for interbody fusion; however, the procedure has several drawbacks, including neural injury, endplate violation, cage subsidence, cage migration, and other critical problems [ 3 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Transforaminal Lumbar Interbody Fusion (TLIF) versus Oblique Lumbar Interbody Fusion (OLIF) in Interbody Fusion Technique for Degenerative Spondylolisthesis: A Systematic Review and Meta-Analysis

Lee

Kim

Choo

et al. 2021

Life

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Preoperative pathology requiring fusion surgery has a great impact on postoperative outcomes. However, the previous clinical and meta-analysis studies did not control for the pathology. In this systematic review, the authors aimed to compare oblique lumbar interbody fusion (OLIF) with transforaminal interbody fusion (TLIF) as an interbody fusion technique in lumbar fusion surgery for patients with degenerative spondylolisthesis (DS). We systematically searched for relevant articles in the available databases. Among the 3022 articles, three studies were identified and met the inclusion criteria. In terms of radiological outcome, the amount of disc height restoration was greater in the OLIF group than in the TLIF group, but there was no significant difference between the two surgical techniques (p = 0.18). In the clinical outcomes, the pain improvement was not significantly different between the two surgical techniques. In terms of surgical outcomes, OLIF resulted in a shorter length of hospital stay and less blood loss than TLIF (p < 0.0001 and p = 0.02, respectively). The present meta-analysis indicated no significant difference in clinical, radiological outcomes, and surgical time between TLIF and OLIF for DS, but the lengths of hospital stay and blood loss were better in OLIF than TLIF. Though encouraging, these findings were based on low-quality evidence from a small number of retrospective studies that are prone to bias.

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“…[8]. Errors in MIS-TLIF have also been linked to post-operative deficits including lower extremity weakness and paralysis [9,10].…”

Section: Figurementioning

confidence: 99%

Developing a Wire Navigation Simulator for Pedicle Screw Placement in Minimally Invasive Transforaminal Lumbar Interbody Fusion

Hill

Long

Williams

et al. 2021

2021 Design of Medical Devices Conference

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Simulation training provides an opportunity for surgeons to learn key skills in a safe environment. This is especially important for surgical procedures where mistakes have high consequences, such as working near the spinal cord. Wire navigation is a common orthopedic skill that spans many procedures. This paper presents the design steps taken to modify an existing simulator intended to train surgeons on hip wire navigation so that it can be used to train surgeons on placing a K-wire during a minimally invasive transforaminal lumbar fusion, or MIS-TLIF. The new design was able to accommodate several unique features of the MIS-TLIF task and successfully simulate placing the guide wire in the pedicle body. Results show that the simulator design functions normally even in the face of hammering needed to place the guide wire, a unique step in this procedure compared with other wire navigation procedures. Additional work remaining involves developing a training curriculum so that surgeons can benefit from this new tool.

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Anterior Versus Transforaminal Lumbar Interbody Fusion: Perioperative Risk Factors and 30-Day Outcomes

Cited by 27 publications

References 39 publications

Interbody Fusions in the Lumbar Spine: A Review

Interbody Fusions in the Lumbar Spine: A Review

Transforaminal Lumbar Interbody Fusion (TLIF) versus Oblique Lumbar Interbody Fusion (OLIF) in Interbody Fusion Technique for Degenerative Spondylolisthesis: A Systematic Review and Meta-Analysis

Developing a Wire Navigation Simulator for Pedicle Screw Placement in Minimally Invasive Transforaminal Lumbar Interbody Fusion

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