POSTERIOR LUMBAR INTERBODY FUSION (PLIF) VS. MINIMALLY
INVASIVE TLIF PROCEDURE
VORSIC MATJAZ,
UNIVERSITY HOSPITAL MARIBOR, Ljubljanska 5, 2000 MARIBOR, SLOVENIA
E-mail: matvorsic@gmail.com
ABSTRACT:
AIM OF THE STUDY:
The surgical treatment of the degenerated lumbar spine may require the transpedicular fixation together with
fusion in order to achieve the rigid stability of the affected motion segment. PLIF procedure is still a golden
standard although other procedures are gaining on popularity such as Transforaminal Interbody Fusion (TLIF),
eXtreme Lateral Interbody Fusion (XLIF) etc.
The aim of the study was to determine the clinical results and the outcome in the patients treated for the lumbar
spondylolisthesis using the standard PLIF procedure or minimally invasive TLIF procedure.
METHODS:
In the study, 24 patients with the painful, lumbar spondylolisthesis (Grade I) were treated with the PLIF
procedure and 16 patients with less invasive TLIF procedure. Clinical outcomes were assessed before, one year
and two years after the procedure using neurological examination, the Oswestry Disability Index (ODI) and
Visual analogue score (VAS) for back and leg pain, with 15 % improvement in ODI and 20 % in VAS defined as
a clinically significant. The X-ray and CT scans of the patients were taken accordingly.
RESULTS:
Forty patients with the stable lumbar spondylolisthesis, treated with either procedure were included in the study
with a minimum follow-up of two years. There was a significant improvement for back and leg pain according to
ODI and VAS score in both groups with no statistically important difference between the two groups. There was
a slightly faster recovery time of the TLIF patients but did not affect the outcome after two years. The fusion rate
was much better with the PLIF group.
CONCLUSIONS:
Both procedures (PLIF and minimally invasive TLIF) resulted in significant pain reduction and good functional
outcome for the patients with better results in the PLIF group regarding the fusion rate.