Transforaminal Lumber Interbody Fusion (TLIF) Clinical and Radiological Outcome

Objective To evaluate the clinical and radiological outcome of TLIF in the treatment of Spondylolisthesis, degenerative disc disease and recurrent herniation of lumber disc. Methodology: A retrospective study, between Jan 2009 and December 2011.The patients with chronic back pain (more than 6 months of disability and refractory to conservative management) with or without leg pain / neurological deficit due to degenerative spondylolisthesis, degenerative disc disease and recurrent lumber disc herniation treated with Transforaminal Lumber Interbody Fusion (TLIF) were included. It was a retrospective review of the patient files to assess the pre and postoperative symptomatology, findings on clinical examination, radiological characteristics. The same procedure was performed in all cases by a single spine surgeon. The clinical outcome was assessed using Oswestry Disability Index (ODI) scoring system. Bony fusion was assessed based on a pre-set criteria on plain radiographs at 18 months postoperatively. Results Of 25 there were 16 male (64%) and 9 female (36%) patients with a mean age of 40 years (range: 20–60), who underwent TLIF (Transforaminal Lumber Interbody Fusion). 9 patients diagnosed as degenerative disc disease, 12 with spondylolisthesis and 4 having recurrent disc herniation. Of the 25 patients who underwent TLIF, in 14 (56%) cases fusion was performed at L5-S1, in 9 (36%) at segment L4-L5 and in 2 (8%) at L3-L4. We found subjective improvement in symptoms of back pain in 19 (76.0%) of 25 patients, leg pain in 15 (83.3%) of 18, and 04 (66.67%) & 02(40.0%) improvement in sensory and motor deficit respectively postoperatively. Based on the Oswestry Disability Index (ODI) and Visual Analog Pain Scale (VAS), showed significant improvement from preoperative 7.1 & 42.3 to 2.5 & 17.5 ODI and VAS scores at 18 months postoperatively respectively, with an overall improvement of 4.6 VAS and 24.8 ODI scores. A radiological fusion was observed at 18 months postoperatively on anterio-posterior (AP) and lateral X-rays following the pre set criteria in 23 of 25 patients (92.00%). Conclusion TLIF is a safe and effective method to treat chronic low back pain in patients with spondylolisthesis, degenerative disc disease and recurrent disc herniation. Our results confirm that TLIF is an option that is associated with good clinical and radiological outcome.