Publication: Comparison of Spinal Alignment between XLIF, TLIF, PLIF, and PLF in the Treatment of Single Level Spondylolisthesis: A Retrospective Study
Issued Date
2021-12-01
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01252208
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2-s2.0-85122627283
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand. Vol.104, No.12 (2021), 1959-1965
Suggested Citation
Ekkapoj Korwutthikulrangsri, Kritchapong Junsri, Monchai Ruangchainikom, Werasak Sutipornpalangkul Comparison of Spinal Alignment between XLIF, TLIF, PLIF, and PLF in the Treatment of Single Level Spondylolisthesis: A Retrospective Study. Journal of the Medical Association of Thailand. Vol.104, No.12 (2021), 1959-1965. doi:10.35755/jmedassocthai.2021.12.13136 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77426
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Title
Comparison of Spinal Alignment between XLIF, TLIF, PLIF, and PLF in the Treatment of Single Level Spondylolisthesis: A Retrospective Study
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Abstract
Background: Most lumbar spinal fusion procedures are performed to increase fusion potential, correct a deformity, and decompress spinal nerve roots. Nowadays, there are several spinal fusion techniques such as extreme lateral lumbar interbody fusion (XLIF), transforaminal lumbar interbody fusion (TLIF), posterior lumbar interbody fusion (PLIF), and posterolateral fusion (PLF). However, there are no studies directly comparing their capacity to alter lumbar lordosis, segmental lordosis, intervertebral disc height, foraminal height, and the grade of slip for treating single level spondylolisthesis in Thailand. Objective: To compare which lumbar interbody technique amongst XLIF, TLIF, PLIF, and PLF, is the most effective in restoring spinal alignment in cases such as lumbar lordosis, increased segmental lordosis, increased intervertebral disc height, increased foraminal height, and a reduced slip grade in spondylolisthesis patients. Materials and Methods: The medical records and radiographs of single level spondylolisthesis patients treated in Siriraj hospital between 2002 and 2017 were retrospectively reviewed. Clinical data and radiographic parameters such as lumbar lordosis, segmental lordosis, intervertebral disc height, foraminal height, and grade of slip, including preoperative and postoperative data were collected and analyzed. An inter-observer/ intra-observer reliability test for all parameters was also performed. Results: Two hundred forty patients including 192 females and 48 males with a mean age of 60.1 years were included in the present study. There was no statistically significant difference in demographic data except in younger patients in the PLF group and those with shorter length of stays in the XLIF group. The present study results indicated that there was a statistically significant increase in lumbar lordosis, increased foraminal height, and decreased slip grade in the XLIF group when compared to other three groups as TLIF, PLIF, and PLF. Conclusion: All spinal fusion techniques could improve lumbar spinal alignment, however, XLIF is superior to other procedures, especially in lumbar lordosis, foraminal height restoration, and slip grade.