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An RCT study comparing the clinical and radiological outcomes with the use of PLIF or TLIF after instrumented reduction in adult isthmic spondylolisthesis

European Spine Journal volume 25, pages 1587–1594 (2016)Cite this article

Abstract

Objective

We prospectively compared posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) used in adult isthmic spondylolisthesis (IS) after surgical reduction with pedicle screws.

Methods

Between January 2009 and December 2010, 66 adult patients with single-level IS were randomly assigned to two groups treated using the PLIF technique (PLIF group, n = 34) and the TLIF technique (TLIF group, n = 32). Both groups were followed up for an average of 30.5 months (range 24–48 months). Clinical outcomes were assessed using the visual analog scale (VAS), Oswestry disability index (ODI) and Japanese orthopedic association (JOA) scores. Radiographic outcomes included percentage of vertebral slippage, focal lordosis and disk height. Clinical and radiographic outcomes were compared between the two groups.

Results

The average operative time and blood loss during surgery were significantly more in PLIF group than in TLIF group. Spondylolisthesis, disk height and focal lordosis were significantly improved postoperatively in both groups. There was no obvious difference in clinical outcomes, as assessed using the VAS, ODI and JOA scores, and radiographic outcomes. In PLIF group, there were two cases of neuropathic pain after surgery.

Conclusions

After instrumented reduction of adult IS, either PLIF or TLIF can provide good clinical and radiological outcomes. With a single cage, TLIF was superior to PLIF in terms of surgical time and blood loss, but these differences may not be clinically relevant.

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Acknowledgments

The authors thank Cameron Rawanduzy from Brain and Spine Center of Weill Cornell Medical College for his helpful discussion and contribution for this manuscript.

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Affiliations

  1. Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China

    Er-Zhu Yang, Jian-Guang Xu, Xiao-Kang Liu, Bing-Fang Zeng & Xiao-Feng Lian

  2. Department of Orthopedics, 101st Hospital of PLA, Wuxi, Jiangsu, China

    Gen-Yang Jin

  3. Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Wenzhen Xiao

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  1. Er-Zhu Yang
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Correspondence to Xiao-Feng Lian.

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Cite this article

Yang, EZ., Xu, JG., Liu, XK. et al. An RCT study comparing the clinical and radiological outcomes with the use of PLIF or TLIF after instrumented reduction in adult isthmic spondylolisthesis. Eur Spine J 25, 1587–1594 (2016). https://doi.org/10.1007/s00586-015-4341-z

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  • DOI: https://doi.org/10.1007/s00586-015-4341-z

Keywords

  • Isthmic spondylolisthesis
  • Surgical reduction
  • Pedicle screws
  • PLIF
  • TLIF