CT-Mapped Fusion Patterns After 360° Transforaminal Lumbar Interbody Fusion (TLIF) for Degenerative...

Area of Science:

• Spine Surgery
• Orthopedics
• Neurosurgery

Background:

• Degenerative spondylolisthesis is a prevalent cause of low back pain and disability.
• Transforaminal lumbar interbody fusion (TLIF) is a common surgical intervention for this condition.
• Evaluating fusion rates and their correlation with clinical outcomes is crucial for optimizing treatment.

Purpose of the Study:

• To compare computed tomography (CT)-confirmed fusion rates across different lumbar regions after TLIF.
• To assess the association between fusion location/extent and patient-reported outcomes.
• To evaluate changes in Oswestry Disability Index (ODI) and Roland-Morris Disability Questionnaire (RMDQ) from baseline to 12 months post-surgery.

Main Methods:

• Retrospective analysis of 88 patients undergoing 360° TLIF.
• Assessment of fusion at seven anatomical zones using 12-month follow-up CT scans.
• Collection of patient-reported outcomes (ODI and RMDQ) at 12 months.

Main Results:

• High fusion success rates were observed, especially for interbody (89.6%) and facet joint fusion.
• The most common surgical levels were L4-L5 and L4-L5+L5-S1.
• Fusion location or number did not correlate with postoperative ODI or RMDQ scores (p > 0.4).
• Complications were infrequent (9.1%), including pedicle fractures and dural injuries.

Conclusions:

• TLIF effectively achieves high CT-confirmed fusion, particularly in interbody and facet joints.
• The anatomical distribution or number of fused zones did not significantly influence 12-month disability outcomes.
• Surgical technique and patient optimization may be more critical than fusion location for clinical success.