We retrospectively reviewed the results of 100 consecutive transforaminal lumbar interbody fusions (TLIFs) performed at one institution. The preoperative diagnoses included degenerative disk disease (55), spondylolisthesis (41; 22 isthmic, 19 degenerative), and degenerative adult scoliosis (4). There were 64 single-level, 33 two-level, 2 three-level, and 1 four-level TLIF (140 levels).
The fusion mass was assessed by an independent observer using biplanar radiography, whereas clinical outcomes were assessed by means of several established outcome measures.
By level, the posterolateral fusion was judged to be probably or definitely solid in 78% of levels, whereas the interbody fusion was radiographically solid in 88% of levels, for an overall 93% fusion success/patient (94%/level). All patients had >24 months of postoperative clinical follow-up, and 82 patients (82%) were available for outcome measure assessment at an average follow-up of 34 months (range 24-61 months) postoperatively. Eighty-one percent of these patients reported a >50% decrease in their symptoms, and 76% of patients were satisfied with their results to the degree that they would have the procedure again. However, a large percentage of patients experienced incomplete relief of their symptoms. Twenty patients sustained minor complications, and there were no major complications.
We conclude that TLIF is a safe and effective method of achieving lumbar fusion with a 93% radiographic fusion success and a nearly 80% rate of overall patient satisfaction but frequently results in incomplete relief of symptoms. Complications resulting from the procedure are uncommon and generally minor and transient.
From the *Department of Orthopaedics and Rehabilitation, Walter Reed Army Medical Center, Washington, DC, †F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, ‡Department of Pathology, Brooke Army Medical Center, San Antonio, TX, §Spine Service, Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, and ∥Spine Surgery, Department of Orthopaedics and Rehabilitation, Walter Reed Army Medical Center, Washington, DC.
Received for publication January 19, 2005; accepted April 5, 2005.
The opinions or assertions contained herein are the private views of some of the authors and are not to be construed as official or as reflecting the views of the United States Army or the Department of Defense. Some authors are employees of the United States government. This work was prepared as part of their official duties and as such, there is no copyright to be transferred.
Reprints: Dr. T. R. Kuklo, LTC(P), MC, U.S. Army, Department of Orthopaedics and Rehabilitation, Walter Reed Army Medical Center, 15619 Thistlebridge Dr., Rockville, MD 20853 (e-mail: Timothy.Kuklo@na.amedd.army.mil).