Comparative Study on the Effectiveness of Posterolateral Fusion vs. Interbody Fusion in Isthmic/Degenerative Spondylolisthesis

Objective:  To compare the effectiveness of posterolateral fusion versus transforaminal lumbar interbody fusion in degenerative/isthmic spondylolisthesis in terms of postoperative pain and postoperative complications. Materials & Methods:  A quasi-experimental study was conducted and 74 patients were included. Group A (n=37) patients underwent PLF, whereas Group B (n = 37) patients underwent TLIF. The pain was assessed with a visual analog scale (VAS), and for disability, the Oswestry Disability Index (ODI) was used. Results:  In Group-A, pre- and post-op back pain mean scores were 3.86 & 0.78, leg pain mean scores were 1.32 & 0.54 while ODI mean scores were 22.51 & 8.59, respectively(P ? 0.05). In Group B, pre- and post-op back pain mean scores were 3.41 & 0.46, leg pain mean scores were 0.84 & 0.30 and ODI mean scores were 19.89 & 6.59, respectively (P > 0.05). The prevalence of minimal disabilities in the TLIF (73%, 78%, 81%, 86%, & 91%) group was relatively more than in the PSF (70%, 75%, 78%, 81%, & 86%) group during pre-op, and post-op phases (2 & 6 weeks, 3 & 6 months). Relatively more patients (8.1% vs. 5.4%) with moderate disability were found in the PSF group as compared to the TLIF group.  Conclusion:  The study concluded that TLIF is a safe and more effective procedure than PLF for isthmic/degenerative spondylolisthesis. It is a better surgical procedure for post-operative back pain, leg pain, complications, and disability.