Clinical and Radiologic 2—4-Year Results of Transforaminal Lumbar Interbody Fusion in Degenerative and Isthmic Spondylolisthesis Grades 1 and 2

Abstract

In Brief Study Design. Prospective clinical study. Objective. To evaluate the clinical and radiographic result of the transforaminal lumbar interbody fusion (TLIF) as an alternative new technique in degenerative and isthmic lower grade spondylolisthesis. Summary of Background Data. TLIF is a new alternative surgical technique used for spinal fusion avoiding the ventral approach and can theoretically prevent typical complications, such as those seen in anterior and posterior lumbar interbody fusion. Materials and Methods. There were 19 degenerative, 19 isthmic, and 1 dysplastic spondylolistheses operated on with TLIF. The clinical follow-up used the Oswestry Disability Index, the radiologic follow-up radiograph, analyzing segmental lordosis, intervertebral space, reduction, and fusion rate. The minimum follow-up was 24 months, mean clinical follow-up was 50 months, and radiologic follow-up was 35 months. Results. The medium of the Oswestry Disability Index in all patients decreased from 23.5 to 13.5 points, in isthmic spondylolistheses from 20.5 to 10.95 after 2 years. The radiographic fusion rate was 94.8%. The sagittal translation was reduced from 23% to 15%. There were 3 (7.6%) serious postoperative complications observed, which required operative revision. Conclusions. TLIF is a safe and effective method to treat low-grade spondylolisthesis, which can theoretically prevent typical complications of anterior and posterior lumbar interbody fusion. The results of isthmic spondylolistheses were significantly better compared to degenerative spondylolistheses. This study presents a clinical and radiologic follow-up of lower grade degenerative and isthmic spondylolistheses. The clinical outcome shows a significant improvement of the whole study population regarding the clinical scores, while the outcome in isthmic spondylolistheses showed a significantly better outcome in comparison to degenerative ones.