Transforaminal lumbar interbody fusion: Clinical and radiographic results and complications in 100 consecutive patients

Benjamin K. Potter, Brett Freedman, Eric G. Verwiebe, Jordan M. Hall, David W. Polly, Timothy R. Kuklo

Research output: Contribution to journalReview article

160 Citations (Scopus)

Abstract

OBJECTIVE: We retrospectively reviewed the results of 100 consecutive transforaminal lumbar interbody fusions (TLIFs) performed at one institution. The preoperative diagnoses included degenerative disk disease (55), spondylolisthesis (41; 22 isthmic, 19 degenerative), and degenerative adult scoliosis (4). There were 64 single-level, 33 two-level, 2 three-level, and 1 four-level TLIF (140 levels). METHODS: The fusion mass was assessed by an independent observer using biplanar radiography, whereas clinical outcomes were assessed by means of several established outcome measures. RESULTS: By level, the posterolateral fusion was judged to be probably or definitely solid in 78% of levels, whereas the interbody fusion was radiographically solid in 88% of levels, for an overall 93% fusion success/patient (94%/level). All patients had >24 months of postoperative clinical follow-up, and 82 patients (82%) were available for outcome measure assessment at an average follow-up of 34 months (range 24-61 months) postoperatively. Eighty-one percent of these patients reported a >50% decrease in their symptoms, and 76% of patients were satisfied with their results to the degree that they would have the procedure again. However, a large percentage of patients experienced incomplete relief of their symptoms. Twenty patients sustained minor complications, and there were no major complications. CONCLUSIONS: We conclude that TLIF is a safe and effective method of achieving lumbar fusion with a 93% radiographic fusion success and a nearly 80% rate of overall patient satisfaction but frequently results in incomplete relief of symptoms. Complications resulting from the procedure are uncommon and generally minor and transient.

Original languageEnglish (US)
Pages (from-to)337-346
Number of pages10
JournalJournal of Spinal Disorders and Techniques
Volume18
Issue number4
DOIs
StatePublished - Aug 1 2005
Externally publishedYes

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Outcome Assessment (Health Care)
Spondylolisthesis
Scoliosis
Patient Satisfaction
Radiography

Keywords

  • Degenerative spondylosis
  • Outcomes
  • Pseudarthrosis
  • Spondylolisthesis
  • Transforaminal lumbar interbody fusion

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Transforaminal lumbar interbody fusion : Clinical and radiographic results and complications in 100 consecutive patients. / Potter, Benjamin K.; Freedman, Brett; Verwiebe, Eric G.; Hall, Jordan M.; Polly, David W.; Kuklo, Timothy R.

In: Journal of Spinal Disorders and Techniques, Vol. 18, No. 4, 01.08.2005, p. 337-346.

Research output: Contribution to journalReview article

Potter, Benjamin K. ; Freedman, Brett ; Verwiebe, Eric G. ; Hall, Jordan M. ; Polly, David W. ; Kuklo, Timothy R. / Transforaminal lumbar interbody fusion : Clinical and radiographic results and complications in 100 consecutive patients. In: Journal of Spinal Disorders and Techniques. 2005 ; Vol. 18, No. 4. pp. 337-346.
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abstract = "OBJECTIVE: We retrospectively reviewed the results of 100 consecutive transforaminal lumbar interbody fusions (TLIFs) performed at one institution. The preoperative diagnoses included degenerative disk disease (55), spondylolisthesis (41; 22 isthmic, 19 degenerative), and degenerative adult scoliosis (4). There were 64 single-level, 33 two-level, 2 three-level, and 1 four-level TLIF (140 levels). METHODS: The fusion mass was assessed by an independent observer using biplanar radiography, whereas clinical outcomes were assessed by means of several established outcome measures. RESULTS: By level, the posterolateral fusion was judged to be probably or definitely solid in 78{\%} of levels, whereas the interbody fusion was radiographically solid in 88{\%} of levels, for an overall 93{\%} fusion success/patient (94{\%}/level). All patients had >24 months of postoperative clinical follow-up, and 82 patients (82{\%}) were available for outcome measure assessment at an average follow-up of 34 months (range 24-61 months) postoperatively. Eighty-one percent of these patients reported a >50{\%} decrease in their symptoms, and 76{\%} of patients were satisfied with their results to the degree that they would have the procedure again. However, a large percentage of patients experienced incomplete relief of their symptoms. Twenty patients sustained minor complications, and there were no major complications. CONCLUSIONS: We conclude that TLIF is a safe and effective method of achieving lumbar fusion with a 93{\%} radiographic fusion success and a nearly 80{\%} rate of overall patient satisfaction but frequently results in incomplete relief of symptoms. Complications resulting from the procedure are uncommon and generally minor and transient.",
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AB - OBJECTIVE: We retrospectively reviewed the results of 100 consecutive transforaminal lumbar interbody fusions (TLIFs) performed at one institution. The preoperative diagnoses included degenerative disk disease (55), spondylolisthesis (41; 22 isthmic, 19 degenerative), and degenerative adult scoliosis (4). There were 64 single-level, 33 two-level, 2 three-level, and 1 four-level TLIF (140 levels). METHODS: The fusion mass was assessed by an independent observer using biplanar radiography, whereas clinical outcomes were assessed by means of several established outcome measures. RESULTS: By level, the posterolateral fusion was judged to be probably or definitely solid in 78% of levels, whereas the interbody fusion was radiographically solid in 88% of levels, for an overall 93% fusion success/patient (94%/level). All patients had >24 months of postoperative clinical follow-up, and 82 patients (82%) were available for outcome measure assessment at an average follow-up of 34 months (range 24-61 months) postoperatively. Eighty-one percent of these patients reported a >50% decrease in their symptoms, and 76% of patients were satisfied with their results to the degree that they would have the procedure again. However, a large percentage of patients experienced incomplete relief of their symptoms. Twenty patients sustained minor complications, and there were no major complications. CONCLUSIONS: We conclude that TLIF is a safe and effective method of achieving lumbar fusion with a 93% radiographic fusion success and a nearly 80% rate of overall patient satisfaction but frequently results in incomplete relief of symptoms. Complications resulting from the procedure are uncommon and generally minor and transient.

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