International Journal of Research in Orthopaedics | May-June 2021 | Vol 7 | Issue 3 Page 544
International Journal of Research in Orthopaedics
Singh H et al. Int J Res Orthop. 2021 May;7(3):544-550
http://www.ijoro.org
Original Research Article
A comparative study of functional outcome between
posterior lumbar fusion and posterior lumbar interbody fusion
in spondylolisthesis
Harpreet Singh, Dhruv Patel*, Sangam Tyagi,
Krushna Saoji, Tilak Patel, Parth Patel
INTRODUCTION
Low back pain is the most common cause of work-related
disability and one of the most common contributors to
missed time at work.
1
Spondylolisthesis is derived from
the Greek words spondyl (vertebra) and olisthesis (to slip).
This most commonly describes the forward slippage of a
cephalad vertebra on a caudal vertebra.
2
Two processes,
dysplastic and traumatic can give rise to spondylolisthesis.
These can occur simultaneously, but generally one
precedes the other.
3
There are various treatment options
available for spondylolisthesis. They are conservative,
epidural steroid injections, only decompression, pars
repair, PLF, PLIF, transforaminal interbody fusion and
circumferential fusion. Conservative treatment for
segmental instability is possible for patients with tolerable
pain.
4
Surgery is indicated if symptoms are disabling and
interfere with work, if the condition is progressive, or if
there is a significant neurological deficit.
5
ABSTRACT
Background: Spondylolisthesis is condition in which one vertebra slips over other vertebra. This study has been done
to compare the functional outcome and complications of two techniques: posterior lumbar fusion (intertransverse
fusion) and posterior lumbar interbody fusion.
Methods: Total 20 patients with spondylolisthesis admitted in a tertiary care centre in Rajasthan were allotted
alternatively in posterior lumbar fusion (PLF) group and posterior lumbar interbody fusion (PLIF) group. In PLF, fusion
was done by placing bone graft between transverse processes and around facets. In PLIF, fusion was bone by placing
cage in between vertebral bodies.
Results: 20 patients were included in our study with female predominance (65%). Mean age was 54.2 years (PLF=58.4
and PLIF=50.2). 70% patients have L4-L5 level spondylolisthesis. Average operative time was less in PLF group, which
is statistically significant. Functional outcome was measured by using visual analogue scale (VAS) score and Japanese
orthopedics association score (JOAS) at 3 weeks, 3 months and 6 months. There is a significant decrease between
preoperative VAS and at 6 months, in both PLF and PLIF group. JOAS was significantly increased at 6 months in both
PLF and PLIF group as compared to preoperative score. But difference in JOAS at 6 months is not significant between
PLF and PLIF.
Conclusions: Both PLF and PLIF are equally effective for spondylolisthesis. Both techniques have same satisfactory
results. As PLIF is more invasive technique, more operative time and more complications are seen.
Keywords: Spondylolisthesis, Posterior lumbar fusion, Posterior lumbar interbody fusion
Department of Orthopaedics, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India
Received: 09 March 2021
Revised: 12 April 2021
Accepted: 13 April 2021
*Correspondence:
Dr. Dhruv Patel,
E-mail: dhruvpateld2408@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: https://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20211608