Troubles neurologiques

Outcomes of Extended Transforaminal Lumbar Interbody Fusion for Lumbar Spondylosis: A Retrospective Cohort Study

Abstract

Adrian J Talia, Michael L Wong, Hui C Lau, Andrew H Kaye

Objectives: The present study aims to assess the results of extended Transforaminal Lumbar Interbody Fusion (TLIF) for a two-surgeon, single institution series.
Methods: 57 cases of extended TLIF with bilateral decompression were performed. Pain, ASIA scores, patient demographics, BMI, perioperative indices and radiographic measurements were recorded and analysed.
Results: 57 operations were performed between February 2011 and January 2014, there were 38 female and 19 male patients. Mean patient age was 62.86 years, mean BMI was 30.31 kg/m2. In 49 patients spondylolisthesis was the primary indication. The mean intraoperative time was 284.65 min, this decreased as the series progressed. The median length of stay was 5 days, ranging from 2 to 9 days. The surgical complication rate was 22.8%. Two patients died from cardiopulmonary complications. 78.9% of the cohort had single-level TLIF, L4/5 was the most commonly fused level. Significant pain reduction was achieved from a mean Pre-operative VAS of 8.28 +/- 1.39 to post-op VAS of 1.50+/-1.05 at 12 months. No patients deteriorated neurologically. Spondylolisthesis was significantly corrected from a pre-operative mean of 6.82 mm to 2.80 mm post-operatively. There is a learning curve associated with the procedure.
Discussion: TLIF with bilateral facet joint removal and decompression appeared to be a safe and effective alternative to other fusion techniques, and is comparable to other published case series. Stabilisation and correction of spinal deformity reduces pain, aids neurologic recovery and improves quality of life.