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. 2018 Feb 24;15(2):359-362.
doi: 10.1016/j.jor.2018.02.017. eCollection 2018 Jun.

Outcome of transforaminal lumbar interbody fusion in spondylolisthesis-A clinico-radiological correlation

Vijay Anand Balasubramanian  1 , Balaji Douraiswami  1 , Suresh Subramani  1
Affiliations

Outcome of transforaminal lumbar interbody fusion in spondylolisthesis-A clinico-radiological correlation

Vijay Anand Balasubramanian et al. J Orthop. .

Abstract

Introduction: Lumbar spondylolisthesis is a common cause of morbidity in middle aged individuals. Spinal fusion with instrumentation has become the gold standard for lumbar segmental instability. Studies which correlate the improvement in radiology postoperatively with functional outcome show contrasting reports. This study is aimed at finding the correlation between clinical and radiological outcomes after surgery with transforaminal lumbar interbody fusion.

Methods: A retrospective study in 35 patients who underwent transforaminal lumbar interbody fusion in a period of 1 year was done. Preoperative pain (VAS Score), functional ability (ODI), radiological parameters (slip angle, slip grade, disc height, foraminal height, lumbar lordosis) were compared with postoperative recordings at the last followup. Functional improvement (Macnab's criteria) and fusion (Lee's fusion criteria) were assessed. Statistical analysis was done with student's paired t-test and Pearson's correlation coefficient.

Results: VAS score, ODI improved from 8 to 2 and 70 to 15 respectively. Slip angle improved from 23°to 5° on an average. 80% patients showed fusion and 85% showed good clinical outcome at 1 year followup. Analyzing with Pearson correlation coefficient showed no significant relation between pain scores and radiological parameters. But there was statistically significant relation between radiological fusion and the final clinical outcome.

Conclusion: TLIF produces spinal fusion in most individuals. Strong spinal fusion is essential for good clinical outcome in spondylolisthesis patients who undergo TLIF. Reduction in slip is not necessary for all patients with listhesis.

Keywords: Lumbar instability; Radiological improvement; Spinal fusion; TLIF.

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Figures

Fig. 1
Fig. 1
Anteroposterior and stress lateral radiographs of the lumbar spine showing spondylolithesis at L4–L5 level.
Fig. 2
Fig. 2
Postoperative radiograph of TLIF showing reduction of listhesis with bean cage and pedicle screws.
Fig. 3
Fig. 3
This chart depicts the improvement in parameters post TLIF surgery when compared with their preoperative values.
Fig. 4
Fig. 4
Illustration of reduction in the scores post surgery.
See this image and copyright information in PMC

References

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