Abstract：Objective To compare the radiographic and clinical results of transforminal lumbar interbody fusion (TLIF) and posterolateral lumbar fusion (PLF) in the treatment of low-grade lumbar spondylolisthesis.Methods We retrospectively reviewed a consecutive cohort of 167 patients with lumbar spondylolisthesis (Meyerding grade Ⅰ-Ⅱ) who received either TLIF or PLF between January 2007 and January 2012 and had a minimum follow-up of 2 years. There were 72 cases with degenerative spondylolisthesis and 95 with isthmic spondylolisthesis, and 103 cases at L4/L5 and 64 at L5/S1, respectively. Among them, 75 patients underwent PLF, including 19 males and 56 females, with the average age of 56.1 years, 92 patients underwent TLIF, including 27 males and 65 females, with the average age of 55.7 years. Disc height, slip angle and slip ratio were measured to evaluate the radiographic outcomes. Oswestry disability index (ODI), Numerical rating scale (NRS) and the MOS item short from health survey (SF-36) were collected to evaluate the clinical results. The radiographic measurements and clinical indexes were recorded pre-and post-operation and at last follow up.Results Shorter operation time [(175.3±46.2)min vs (228.3±52.1)min, t=6.877, P<0.01] and less estimated blood loss [(415.3±101.7)mL vs (620.5±125.9)mL, t=11.403, P<0.01] were observed in PLF versus TLIF. The complications related to instrumentation had no significant differences between groups in mean follow-up of 35 months (Range, 24-84 months). There were no difference between TLIF group and PLF group in terms of disc height, slip angle and slip ratio preoperatively(all P values＞0.05). Postoperative radiographic results showed that patients of both groups had significant improvement in all oberzevation items(all P values<0.01), but without significant difference between groups in slip ratio, slip angle and disc height(all P values＞0.05). Till the latest follow-up, TLIF was found to be superior to PLF in maintenance of disc height and avoidance of reduction loss as well(all P values<0.05). The ODI, NRS and SF-36 scores were significantly improved after surgery and at last follow up, while demonstrating no significant difference between the two groups(all P values＞0.05).Conclusions Both TLIF and PLF are effective in treating Meyerding grade Ⅰ-Ⅱ lumbar spondylolisthesis, whereas TLIF is superior to PLF in maintenance of disc height and avoidance of reduction loss.
陈曦,孙旭,陈忠辉,王斌,刘臻,朱泽章,钱邦平,邱勇. 经椎间孔椎体间融合与后外侧融合治疗轻度腰椎滑脱症的中期随访对比研究[J]. 中华解剖与临床杂志, 2015, 20(4): 287-292.
Chen Xi, Sun Xu, Chen Zhonghui, Wang Bin, Liu Zhen, Zhu Zezhang, Qian Bangping, Qiu Yong.. Transforminal lumbar interbody fusion versus posterolateral lumbar fusion in treatment of lumbar spondylolisthesis: a mid-term follow-up study. Chinese Journal of Anatomy and Clinics, 2015, 20(4): 287-292.
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2015, Vol. 20 
