A Comparison of Posterior Lumbar Interbody Fusion and Transforaminal Lumbar Interbody Fusion: a Literature Review and Meta-analysis

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2014 Nov 7

PMID 25373605

Citations 37

Authors

Qunhu Zhang

Zhen Yuan

Min Zhou

Huan Liu

Yong Xu

Yongxin Ren

Affiliations

Soon will be listed here.

Abstract

Background: We compared the perioperative results and complications associated with PLIF and TLIF, and collected evidence for choosing the better fusion method.

Methods: A literature survey of the MEDLINE and EMBASE databases identified 7 comparative observational studies that met our inclusion criteria. Checklists by Cowley were used to evaluate the risk of bias of the included studies. A database including patient demographic information, perioperative results, and complications was established. The summary odds ratio and weighed mean difference with 95% confidence interval were calculated with a random-effects model.

Results: We found that PLIF had a higher complication rate (P <0.00001), and TLIF reduced the rate of durotomy (P = 0.01). No statistical difference was found between the two groups with regard to clinical satisfaction (P = 0.54), blood loss (P = 0.14), vertebral root injury (P = 0.08), graft malposition (P = 0.06), infection (P = 0.36), or rate of radiographic fusion (P = 0.27). The evidence indicated that PLIF required longer operative time (P = 0.03).

Conclusions: The evidence indicated that TLIF could reduce the complication rate and durotomy. Neither TLIP nor PLIF was found superior in terms of clinical satisfaction or radiographic fusion rate. PLIF might result in longer time in surgery.

Citing Articles

Clinical, Radiological, and Functional Evaluations of the Anterior-to-Psoas Lumbar Interbody Fusion Approach With Posterior Decompression and Osteotomy for Treating Patients With Adult Spinal Deformity: A Retrospective Study.

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A Comparative Study Between Posterolateral Lumbar Fusion and Transforaminal Lumbar Interbody Fusion for Degenerative Lumbar Spondylolisthesis.

Reddy A B, S N, Ramachandraiah M Cureus. 2025; 16(12):e76022.

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Minimally Invasive versus Traditional Surgery: Efficacy of PELD and PLIF in Treating Pyogenic Spondylodiscitis.

Liu Y, Wu T, Tan J, Miao X, Tang T, Cai C Med Sci Monit. 2024; 30:e943176.

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Evolution of the Transforaminal Lumbar Interbody Fusion (TLIF): From Open to Percutaneous to Patient-Specific.

Drossopoulos P, Ononogbu-Uche F, Tabarestani T, Huang C, Paturu M, Bardeesi A J Clin Med. 2024; 13(8).

PMID: 38673544 PMC: 11051479. DOI: 10.3390/jcm13082271.

Bibliometric analysis of transforaminal lumbar interbody fusion: research status, trends, and future directions.

Wang X, Zhang A, Yao W, Qiu H, Feng F EFORT Open Rev. 2023; 8(12):906-918.

PMID: 38038386 PMC: 10714383. DOI: 10.1530/EOR-23-0155.

References

Audat Z, Moutasem O, Yousef K, Mohammad B . Comparison of clinical and radiological results of posterolateral fusion, posterior lumbar interbody fusion and transforaminal lumbar interbody fusion techniques in the treatment of degenerative lumbar spine. Singapore Med J. 2012; 53(3):183-7. View

Mehta V, McGirt M, Garces Ambrossi G, Parker S, Sciubba D, Bydon A . Trans-foraminal versus posterior lumbar interbody fusion: comparison of surgical morbidity. Neurol Res. 2010; 33(1):38-42. DOI: 10.1179/016164110X12681290831289. View

Yan D, Li J, Gao L, Soo C . [Comparative study on two different methods of lumbar interbody fusion with pedicle screw fixation for the treatment of spondylolisthesis]. Zhonghua Wai Ke Za Zhi. 2008; 46(7):497-500. View

Lin P . A technical modification of Cloward's posterior lumbar interbody fusion. Neurosurgery. 1977; 1(2):118-24. DOI: 10.1227/00006123-197709000-00006. View

Starkweather A . Posterior lumbar interbody fusion: an old concept with new techniques. J Neurosci Nurs. 2006; 38(1):13-20, 30. DOI: 10.1097/01376517-200602000-00005. View

Vlaanderen J, Vermeulen R, Heederik D, Kromhout H . Guidelines to evaluate human observational studies for quantitative risk assessment. Environ Health Perspect. 2008; 116(12):1700-5. PMC: 2599766. DOI: 10.1289/ehp.11530. View

Schnee C, Freese A, Ansell L . Outcome analysis for adults with spondylolisthesis treated with posterolateral fusion and transpedicular screw fixation. J Neurosurg. 1997; 86(1):56-63. DOI: 10.3171/jns.1997.86.1.0056. View

Tian N, Wu Y, Zhang X, Xu H, Chi Y, Mao F . Minimally invasive versus open transforaminal lumbar interbody fusion: a meta-analysis based on the current evidence. Eur Spine J. 2013; 22(8):1741-9. PMC: 3731475. DOI: 10.1007/s00586-013-2747-z. View

Ye Y, Xu H, Chen D . Comparison between posterior lumbar interbody fusion and posterolateral fusion with transpedicular screw fixation for isthmic spondylolithesis: a meta-analysis. Arch Orthop Trauma Surg. 2013; 133(12):1649-55. PMC: 3828496. DOI: 10.1007/s00402-013-1868-5. View

10.

Liu X, Wang Y, Qiu G, Weng X, Yu B . A systematic review with meta-analysis of posterior interbody fusion versus posterolateral fusion in lumbar spondylolisthesis. Eur Spine J. 2013; 23(1):43-56. PMC: 3897839. DOI: 10.1007/s00586-013-2880-8. View

11.

Mukai Y, Takenaka S, Hosono N, Miwa T, Fuji T . Intramuscular pressure of the multifidus muscle and low-back pain after posterior lumbar interbody fusion: comparison of mini-open and conventional approaches. J Neurosurg Spine. 2013; 19(6):651-7. DOI: 10.3171/2013.8.SPINE13183. View

12.

Sakeb N, Ahsan K . Comparison of the early results of transforaminal lumbar interbody fusion and posterior lumbar interbody fusion in symptomatic lumbar instability. Indian J Orthop. 2013; 47(3):255-63. PMC: 3687902. DOI: 10.4103/0019-5413.111484. View

13.

Rosenberg W, Mummaneni P . Transforaminal lumbar interbody fusion: technique, complications, and early results. Neurosurgery. 2001; 48(3):569-74; discussion 574-5. DOI: 10.1097/00006123-200103000-00022. View

14.

Jacobs W, Vreeling A, de Kleuver M . Fusion for low-grade adult isthmic spondylolisthesis: a systematic review of the literature. Eur Spine J. 2005; 15(4):391-402. PMC: 3489314. DOI: 10.1007/s00586-005-1021-4. View

15.

GJESSING M . Osteoplastic anterior fusion of the lower lumbar spine in spondylolisthesis, localized spondylosis, and tuberculous spondylitis. Acta Orthop Scand. 1951; 20(3):200-13. DOI: 10.3109/17453675108991168. View

16.

Stroup D, Berlin J, Morton S, Olkin I, Williamson G, Rennie D . Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000; 283(15):2008-12. DOI: 10.1001/jama.283.15.2008. View

17.

Lian X, Hou T, Xu J, Zeng B, Zhao J, Liu X . Posterior lumbar interbody fusion for aged patients with degenerative spondylolisthesis: is intentional surgical reduction essential?. Spine J. 2013; 13(10):1183-9. DOI: 10.1016/j.spinee.2013.07.481. View

18.

Mura P, Costaglioli M, Piredda M, Caboni S, Casula S . TLIF for symptomatic disc degeneration: a retrospective study of 100 patients. Eur Spine J. 2011; 20 Suppl 1:S57-60. PMC: 3087043. DOI: 10.1007/s00586-011-1761-2. View

19.

Weistroffer J, Perra J, Lonstein J, Schwender J, Garvey T, Transfeldt E . Complications in long fusions to the sacrum for adult scoliosis: minimum five-year analysis of fifty patients. Spine (Phila Pa 1976). 2008; 33(13):1478-83. DOI: 10.1097/BRS.0b013e3181753c53. View

20.

Gu G, Zhang H, Fan G, He S, Cai X, Shen X . Comparison of minimally invasive versus open transforaminal lumbar interbody fusion in two-level degenerative lumbar disease. Int Orthop. 2013; 38(4):817-24. PMC: 3971284. DOI: 10.1007/s00264-013-2169-x. View