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Related Experiment Video

Updated: Jul 6, 2025

Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion
10:24

Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion

Published on: June 6, 2025

109

Supplementary posterior fusion in patients operated on employing TLIF may decrease the instrumentation failure rate.

Andrey Bokov1, Svetlana Kalinina2, Mingiyan Khaltyrov2

  • 1Institute of Traumatology and Orthopedics, Privolzhsky Research Medical University, Nizhny Novgorod, Russia.

Frontiers in Surgery
|January 8, 2024
PubMed
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Adding posterior fusion to transforaminal lumbar interbody fusion (TLIF) surgery reduces pedicle screw loosening and instrumentation failure. This circumferential fusion approach enhances spinal stability and may decrease the need for revision surgery.

Area of Science:

  • Spine surgery
  • Orthopedic surgery
  • Neurosurgery

Background:

  • The clinical benefit of additional posterior fusion with transforaminal lumbar interbody fusion (TLIF) for spinal stability is not well-established.
  • Pedicle screw loosening is a concern in TLIF procedures.

Purpose of the Study:

  • To evaluate the clinical efficacy of circumferential fusion in patients undergoing TLIF.
  • To assess the impact of additional posterior fusion on pedicle screw stability and instrumentation failure.

Main Methods:

  • Retrospective analysis of 179 patients with degenerative lumbar stenosis and instability treated with TLIF.
  • 118 patients received supplementary posterior fusion.
  • Logistic regression analysis was used to determine factors influencing complication rates.
Keywords:
circumferential fusiondegenerative diseaseslumbar spineposterior fusionscrew looseningtransforaminal lumbar interbody fusion

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Last Updated: Jul 6, 2025

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Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
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Main Results:

  • Increased pedicle screw loosening correlated with decreased radiodensity and two-level fusions.
  • Posterior fusion (complete or incomplete) was associated with a decline in complication rates.
  • Additional posterior fusion significantly decreased instrumentation failure requiring revision surgery (OR=24.98, p=0.0023).

Conclusions:

  • Circumferential fusion, combining TLIF with posterior fusion, reduces pedicle screw loosening.
  • This approach is linked to a lower rate of clinically significant instrumentation failure after TLIF.