Posterior vs Transforaminal Lumbar Interbody Fusion
The optimal treatment for degenerative lumbar diseases remains controversial. The currently recommended surgical procedures are the anterior lumbar interbody fusion, the posterior lumbar interbody fusion (PLIF), and the transforaminal lumbar interbody fusion (TLIF). The PLIF and TLIF are the more commonly implemented.
PLIF was first described by Cloward in 1940 and became commonly used after modifications were proposed by Lin. PLIF can only be performed through the posterior approach, and it enables a stable three-column fixation with 360° fusion and anterior support. In 1982, Harms and Rolinger first described the TLIF technique for creating a circumferential fusion via a single posterolateral approach. As reported by Audat et al., in 1998 Harms and Rolinger reported the treatment outcomes of 191 patients who received TLIF between 1993 and 1996. This procedure involves the placement of pedicle screws and an interbody spacer via a single posterolateral route.
Many studies have compared methods for lumbar interbody fusion with regard to clinical results and fusion rates. However, the inconsistent results of these studies do not provide sufficient evidence to determine which is the optimal fusion technique. The present study is a meta-analysis, conducted to provide cumulative effect estimates of clinical outcomes and to determine which surgical technique is more beneficial.
Background
The optimal treatment for degenerative lumbar diseases remains controversial. The currently recommended surgical procedures are the anterior lumbar interbody fusion, the posterior lumbar interbody fusion (PLIF), and the transforaminal lumbar interbody fusion (TLIF). The PLIF and TLIF are the more commonly implemented.
PLIF was first described by Cloward in 1940 and became commonly used after modifications were proposed by Lin. PLIF can only be performed through the posterior approach, and it enables a stable three-column fixation with 360° fusion and anterior support. In 1982, Harms and Rolinger first described the TLIF technique for creating a circumferential fusion via a single posterolateral approach. As reported by Audat et al., in 1998 Harms and Rolinger reported the treatment outcomes of 191 patients who received TLIF between 1993 and 1996. This procedure involves the placement of pedicle screws and an interbody spacer via a single posterolateral route.
Many studies have compared methods for lumbar interbody fusion with regard to clinical results and fusion rates. However, the inconsistent results of these studies do not provide sufficient evidence to determine which is the optimal fusion technique. The present study is a meta-analysis, conducted to provide cumulative effect estimates of clinical outcomes and to determine which surgical technique is more beneficial.
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