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TLIF yielded better outcomes vs PSF for treatment of spondylolisthesis
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Investigators of this study found more favorable outcomes in the Oswestry Disability Index for patients with spondylolisthesis who underwent transforaminal lumbar interbody fusion compared with posterolateral spinal fusion; however, this trend was not seen for patients with either spinal stenosis or adjacent segment disease.
Researchers used the National Neurosurgical Quality and Outcomes Database to identify 306 patients who underwent posterolateral spinal fusion (PSF) and 1,230 patients who underwent transforaminal lumbar interbody fusion (TLIF). Investigators categorized the patients based on specific diagnostic reasons for surgery. Patients who underwent PSF within each of the subgroups were propensity-matched to patients who underwent TLIF, with sufficient controls seen for patients with spondylolisthesis, spinal stenosis and adjacent segment disease.
Results showed patients who underwent PSF or TLIF in the three propensity-matched subgroups had similar OR times, estimated blood loss and length of stay. Investigators noted patients who underwent PSF compared with patients in the TLIF group had greater improvements in the Oswestry Disability Index (ODI) at 3 months. At 12 months, the TLIF group had a higher proportion of patients who reached a minimal clinically important difference. Patients who underwent PSF or TLIF in both the spine stenosis and adjacent segment disease subgroups were not different with regard to improvements in the ODI. ‒ by Monica Jaramillo
Disclosures: Glassman reports he receives royalties for patents from Medtronic. Please see the full study for a list of all other authors’ relevant financial disclosures.
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