*Title: Mini-Transforaminal Lumbar Interbody Fusion Versus Anterior Lumbar Interbody fusion Augmented by Percutaneous Pedicle Screw Fixation.
*Author: Jin-Sung Kim, MD, Byung-Uk Kang, MD, Sang-Ho Lee, MD, PhD, Byungjoo Jung, MD, PhD, Young-Gun Choi, MD, Sang Hyeop Jeon, MD Ho Yeon Lee, MD, PhD
*Bibliography: J Spinal Disord Tech. 2009 Apr;22(2):114-21.
Study Design: Retrospective clinical data analysis.
Objective: To compare clinical results with radiologic results of 2 fusion techniques for adult low-grade isthmic spondylolisthesis.
Summary of Background Data: There is clear evidence that comparing ALIF versus PLIF.
However, there are no recent studies that compare these 2 fusion techniques(ALIF and TLIF).
-patient characteristics (2004.03~2004.12)
1) presence of single-level low-grade isthmic spondylolisthesis
2) chronic and persistent radiculopathy despite conservative treatment
3) progressive neurologic deficits
4) persistent and unremitting lower-back pain for more than 6months
5) loss of quality of life because of neurologic claudication
6) minimum follow-up period 2years
7) age range of 18 to 65 years
1) previous spine surgery
2) concomitant scoliosis of more than 15 degrees
3) compression fracture or instability at the adjacent segment
4) underwent simultaneous decompression at adjacent segments
evaluated on anteroposterior, lateral, and flexion-extension radiographs.
Radiologic data: 1)disc height 2) segmental lordosis 3) whole lumbar lordosis 4) degree of listhesis
<radiologic measurement method>
Clinical outcome: 1) VAS(visual analog scale) 2) ODI(oswestry disability index)
-All ALIF procedures were performed using the mini-laparotomic retroperitoneal approach.
>Mini-TLIF with PPF
-An analysis of variance was conducted using the 2 proportions test, independent 2 sample t test, x^test, paired t test. (p<0.05)
The postoperative radiologic data revealed below.
-DH and SL --> significant difference
-degree of listhesis and WL--> Not significant difference
ALIF- back: 7.7 --> 2.9
leg: 7.5--> 2.7
TLIF- back: 7.0 --> 2.3
leg: 6.3--> 2.2
ALIF: 51.4%--> 23.2%
TLIF: 52% --> 14.4%
-The mini-ALIF group demonstrated key radiographic advantages compared with the mini-TLIF group for adult low-grade isthmic spondylolisthesis.
-However, clinical and functional outcomes did not demonstrate significant differences between groups.