Objective
To assess the clinical and radiographic results in consecutive patients who underwent transforaminal lumbar interbody fusion(TLIF) for primarily degenerative indications.
Methods
Between March 1999 and July 2002, 63 patients(19 male and 44 female, range of age 38節67) were underwent TLIF using local and/or iliac bone graft in- and out-side of titanium mesh cage with supplemental pedicle screw fixation. We retrospectively reviewed the records of the patients and analysed radiographic data including the bony fusion, the total lumbar lordosis, segmental lordosis and disc height ratio. Clinical results were measured by modified Whitecloud functional scale.
Results
There were 38 degenerative spondylolisthesis, 11 isthmic spondylolisthesis, 9 degenerative stenosis, 3 recurrent disc herniation, 1 degenerative disc disease and 1 post-surgical spondylolisthesis. TLIF was performed at L4-5 in 51 patients, L5-S1 in 6 patients, L3-4 in 6 patients. Posterolateral fusion was added in 21 patients. Clinical follow-up was available for mean 41 months(range: 25節65months). On criteria for the clinical outcome by Whitecloud, fifty-seven patients(90.5%) had excellent or good clinical outcomes. Postoperative segmental lordosis and total lumbar lordosis increased 34.2% and 7% respectively. Compared with preoperative measurement of the disc height, we obtained 29.5% increase of disc height at 1 month follow-up and 18.2% increase at last follow-up. Sixty-one patients(96.8%) had solid or probable fusions radiographically at latest follow-up.
Conclusion
In terms of its clinical efficacy and postoperative morbidity, transforaminal lumbar interbody fusion seems to be a effective circumferential fusion method in the management of various degenerative disease of the lumbar spine.
