Transforaminal lumbar interbody fusion with one cage in degenerative spondylolisthesis

الملخص EN

Background : The transforaminal lumbar interbody fusion (TLIF) procedure was developed to provide the surgeon with a fusion procedure that may reduce many of the risks and limitations associated with posterior lumbar interbody fusion, yet produce similar stability in the spine.

We performed a prospective study to evaluate the outcome and safety of instrumented TLIF with 1 diagonal cage for degenerative spondylolisthesis in the Suez Canal University hospital.

Methods : Between June 2007 and November 2009, 20 patients (14 men and 6 women ; mean age 52.5 years, range 39–61 years) with symptomatic degenerative spondylolisthesis underwent the TLIF procedure with 1 banana shaped carbon fiber cage and additional pedicle screw internal fixation.

The inclusion criteria involved degenerative spondylolisthesis (Grades I and II) in patients with chronic low-back pain with leg pain.

Results : Two patients had a postoperative temporary motor and sensory deficit related to the adjacent nerve root (L5).

Two patients had a dural tear that were sutured during surgery.

No implant fracture or subsidence occurred in any patient.

Clinically, the pain index and activities of daily living (Oswestry) score improved significantly from before surgery to the 1-year follow-up, the pain index improved from 9.1 to 3.1 (p < 0.001).

The postoperative (Oswestry) score showed a significant postoperative reduction of disability during the whole period of follow-up (p < 0.001).

The preoperative mean (Oswestry) score was 9, and postoperative 17.

Disc space height and foraminal height were restored by the surgery and maintained at the latest follow-up time.

Conclusion : instrumented TLIF with single cage can be a surgical option for treatment of degenerative spondylolisthesis as complications resulting from the procedure are uncommon and generally minor and transient.