What is the Optimum Fusion Technique for Adult Isthmic Spondylolisthesis—PLIF or PLF? A Long-Term Prospective Cohort Comparison Study

Cunningham, John; Elling, Elizabeth Mary; Milton, Abul Hasnat; Robertson, Peter A.

doi:10.1097/bsd.0b013e3182417103

Cited by 29 publications

(26 citation statements)

References 24 publications

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“…There are different types of surgical method or techniques that have been developed in past years to achieve fusion and reduction for the deformity of isthmic spondylolisthesis, [5,[41][42][43][44][45][46][47][48][49][50][51][52][53] but it is difficult to define the ideal surgical strategy for IS in adults based on the published data [54][55][56]. Each procedure has its own advantages and disadvantages; the basic principle of surgical treatment is decompression and stabilization.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Simple Lumbar Interbody Fusion with CircumferentialFusion for Treatment of Isthmic Spondylolisthesis

Akter¹,

Hasan²,

Sana³

et al. 2017

Orthop Muscular Syst

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Purpose: Spondylolisthesis is a common cause of surgery in patients with lower back pain. Although interbody fusion and circumferential fusion are a relatively common surgical method for the treatment of spondylolisthesis, we retrospectively compared surgical reduction or fusion in situ with simple lumbar interbody fusion (PLIF/TLIF) and circumferential fusion (PLF+TLIF/PLIF) for adult isthmic spondylolisthesis in terms of surgical invasiveness, clinical and radiographical outcomes, and complications.Methods: From January 2013 to June 2015, 84 adult patients with isthmic spondylolisthesis who underwent surgical treatment in our department were randomized to simple lumbar interbody fusion (PLIF/TLIF) group (group 1, n=45) and circumferential fusion (PLF+TLIF/PLIF) group (group 2, n=39), and followed up for average 28.6 months (range 24-54 months). All patients of both groups had low back pain as their predominant symptom, with varying degree of radicular pain and neurological symptoms. The data collected retrospectively for analysis were: duration of symptoms, levels of fusion, revision surgery, clinical and radiographic results after surgery, and complications. Results:All the 84 patients compared in two surgical approaches for IS were included in this retrospective studies. In our analysis, for the surgical management of isthmic spondylolisthesis, we indicated that both approaches lumbar interbody fusion (PLIF/TLIF) and circumferential fusion (PLF+TLIF/PLIF) have equal significant, greater fusion rates with successful clinical outcomes. Conclusion:Our clinical experience along with statistic findings indicates that in conclusion, there was no significant difference was found between simple interbody fusion (PLIF/TLIF) compared to circumferential fusion (PLF+TLIF/PLIF). Moreover, both techniques led to similar surgical outcomes and complication during follow-up. Thus, these results suggest that both procedures are equally effective for the treatment of isthmic spondylolisthesis. Keywords: Introduction BackgroundSpinal fusion technique was introduced 70 years ago for the treatment of degenerative disc disease and chronic lower back pain [1]. Hibbs and Albee were two spine surgeons in 1911, who performed first spinal stabilization surgery [2,3]. Forward displacement of a vertebral bone in sequence of normal alignment of vertebra is called Isthmic Spondylolisthesis-most commonly due to progressive vertebral body malalignment in the lumbar region of spine. Even in severe case of spondylolisthesis, the slipped vertebra is comfortably reduced by the modern surgical techniques [4][5][6][7].However, these operations have high risk of neurological complications from the implant and screws, even in correct procedure, there areneurological complications [8]. There are no significant neurological complication differences found between the reduction procedure and fusion situ [5,[8][9][10]. About 90% of all vertebral body slips due to the degenerative and isthmic types of spondylolisthesis [11]. Generally in populati...

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Section: Discussionmentioning

confidence: 99%

Comparison of Simple Lumbar Interbody Fusion with CircumferentialFusion for Treatment of Isthmic Spondylolisthesis

Akter¹,

Hasan²,

Sana³

et al. 2017

Orthop Muscular Syst

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“…In another study by Ekman [20], after 2 year follow up both PLF and PLIF has shown only equal results. In long term cohort study by Cunningham [7], PLIF has shown superior results compared to PLF. In another study by Kee Yong [21] pre op instability is said to play a major role whether addition lumbar interbody fusion would be beneficial or not.…”

Section: Follow Upmentioning

confidence: 97%

“…PLIF had been proved to be superior to PLF in certain studies [6,7,[9][10][11][12][13][14][15][16] whereas certain studies show that PLF is better [8,10,11]. There is a definitive indication to compare both the techniques which is the primary aim of our study.…”

Section: Introductionmentioning

confidence: 96%

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Treatment of Adult Spondylolisthesis: PLIF versus PLF: Comparitive Study of Early Functional Outcome

Rn¹,

BALAKRISHNAN²

2017

J Clin Exp Orthop

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Objective: Aim of this study is to assess and compare the early functional outcomes and results of posterior lumbar interbody fusion (PLIF), and posterolateral fusion (PLF) in the surgical treatment of adult spondylolisthesis.Background: Posterolateral fusion has been considered the best method for surgical treatment of adult spondylolisthesis. This technique had been widely used. Superior results have subsequently been reported with interbody fusion with cages and posterior instrumentation. In axial loading pull out strength and eccentric loading remains a disadvantage for PLF. The problems such as axial pain, loss of reduction, loosening or failure of fixation materials occurred relatively frequently after posterolateral fusion could be improved by an operation that fused vertebral bodies.

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“…Lumbar and lumbosacral fusion using the pedicle screw system and interbody fusion (IBF) technique is a popular surgical procedure, with satisfactory clinical outcomes and high union rates (7,21,30,33). Since the PLF technique is insufficient for obtaining spinal stability, a number of IBF techniques are developed such as spinous process or iliac wing autografts, allografts, cage, or their combination (10, 11, 20, 21, 34).…”

Section: Yılmaz T Et Al: Modified Technique For Isthmic Spondylolistmentioning

confidence: 99%

A modified technique for the treatment of isthmic spondylolisthesis

Yılmaz

Dalbayrak²,

Yaman³

et al. 2014

Turkish Neurosurgery

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What is the Optimum Fusion Technique for Adult Isthmic Spondylolisthesis—PLIF or PLF? A Long-Term Prospective Cohort Comparison Study

Cited by 29 publications

References 24 publications

Comparison of Simple Lumbar Interbody Fusion with CircumferentialFusion for Treatment of Isthmic Spondylolisthesis

Comparison of Simple Lumbar Interbody Fusion with CircumferentialFusion for Treatment of Isthmic Spondylolisthesis

Treatment of Adult Spondylolisthesis: PLIF versus PLF: Comparitive Study of Early Functional Outcome

A modified technique for the treatment of isthmic spondylolisthesis

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