Comparison of PLIF and TLIF in the Treatment of LDH Complicated with Spinal Stenosis

Abstract

Objective. The purpose was to compare the clinical effects of posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of lumbar disc herniation (LDH) complicated with spinal stenosis. Methods. 96 LDH patients complicated with spinal stenosis treated in our hospital (April 2018–April 2020) were chosen as the subjects, and split into the PLIF group and the TLIF group according to different surgical approaches, with 48 cases in each group. The clinical effects of the two groups were compared. Results. There was no significant difference in hospitalization time between the two groups ( P > 0.05 ). Compared with the PLIF group, the TLIF group had obviously shorter operation time and greatly lesser intraoperative blood loss ( P < 0.05 ). The Numerical Rating Scale (NRS) scores of lower limb pain and low back pain in the two groups at 3 months after surgery were significantly lower than those before surgery ( P < 0.001 ). The Japanese Orthopaedic Association (JOA) scores of the two groups at 3 months after surgery were significantly higher than those before surgery ( P < 0.001 ). The Spitzer Quality of Life Index (SQLI) scores of the two groups at 3 months after surgery were significantly higher than those before surgery ( P < 0.001 ). Conclusion. The two surgical approaches have similar efficacy in treating LDH complicated with spinal stenosis. However, PLIF is better than TLIF in terms of operation time and intraoperative blood loss, which should be adopted as the preferred surgical scheme.

Safety and Efficacy of Cortical Bone Trajectory Screw Fixation Combined with Facet Fusion for the Treatment of Lumbar Degenerative Disease

“…However, PLIF is more invasive, and it is inevitable to retract the dural sac and nerve root during the operation, so the risk of nerve injury is high 6,7 . Although TLIF has the advantage of less invasion, it has high requirements for operation techniques, more intraoperative blood loss, and a high incidence of postoperative complications 8,9 . Mainstream lumbar fusion techniques have different shortcomings, spine surgeons have been seeking less invasive methods of achieving complete decompression with satisfactory fusion rates 10 …”

“…6,7 Although TLIF has the advantage of less invasion, it has high requirements for operation techniques, more intraoperative blood loss, and a high incidence of postoperative complications. 8,9 Mainstream lumbar fusion techniques have different shortcomings, spine surgeons have been seeking less invasive methods of achieving complete decompression with satisfactory fusion rates. 10 In recent years, facet fusion (FF) has received more and more attention in practice.…”

Clinical Effect of Minimally Invasive Microendoscopic‐Assisted Transforaminal Lumbar Interbody Fusion for Single‐Level Lumbar Disc Herniation

“…Patients with LDH prefer to choose surgical decompression of the neural elements and stabilize spinal fusion after invalid non‐operative treatment 3,4 . Currently, transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF) are two widely used types of surgery for LDH therapy 5–7 . The indications for lumbar interbody fusion mainly include: low back pain, lumbar disc herniation, neurogenic claudication, radiculopathy due to foraminal stenosis, spinal instability, and lumbar degenerative spinal deformity that includes symptomatic spondylolisthesis, and degenerative scoliosis 8–10 .…”

“… 3 , 4 Currently, transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF) are two widely used types of surgery for LDH therapy. 5 , 6 , 7 The indications for lumbar interbody fusion mainly include: low back pain, lumbar disc herniation, neurogenic claudication, radiculopathy due to foraminal stenosis, spinal instability, and lumbar degenerative spinal deformity that includes symptomatic spondylolisthesis, and degenerative scoliosis. 8 , 9 , 10 The carragee grading as shown in Figure 1 is helpful in understanding disc herniation and nerve root compression.…”

Differentiated tactics of surgical treatment of intervertebral disc herniation complicated by spinal canal stenosis

“…При виконанні операцій на хребті важливе значення має не лише хірургічна техніка, а і вибір методу стабілізації. Так, за даними різних авторів, метод TLIF (transforaminal lumbar interbody fusion) порівняно з методом PLIF (posterior lumbar interbody fusion) харак теризує ться меншими триваліс тю операції та об'ємом крововтрати, тому йому слід віддавати перевагу [20,21]. Існує багато публікацій, присвячених оперативним втручанням при ДСПВХ, але переконливих доказів переваг певного методу лікування немає [14].…”