Fusion's Location and Quality within the Fixated Segment Following Transforaminal Interbody Fusion (TLIF)

Area of Science:

• Spine surgery
• Orthopedics
• Radiology

Background:

• Transforaminal interbody fusion (TLIF) is a common surgical procedure for lumbar spine pathologies.
• While fusion rates are generally reported as high, detailed analysis of fusion location and quality is limited.

Purpose of the Study:

• To evaluate the location and quality of fusion after TLIF surgery using computed tomography (CT) scans.
• To compare fusion rates in the posterolateral and intervertebral body areas post-TLIF.

Main Methods:

• Retrospective study of 48 patients who underwent TLIF surgery between 2010 and 2020.
• Post-operative CT scans, taken at least 1 year after surgery (median 2 years), were analyzed.
• Fusion quality was assessed using Lee's criteria in both posterolateral and intervertebral body regions.

Main Results:

• Definitive fusion in both posterolateral and intervertebral areas was achieved in 48% of patients.
• 92% of patients demonstrated definitive fusion in at least one area.
• Significantly higher definitive fusion rates were observed in the posterolateral area (92%) compared to the intervertebral body area (52%) (p < 0.001).

Conclusions:

• The posterolateral area demonstrates a significantly higher rate of definitive fusion compared to the intervertebral body area following TLIF.
• Surgeons are advised to prioritize bone augmentation material in the posterolateral region during TLIF procedures.