Our Summary

This research paper compares two types of surgeries used to treat a condition called degenerative luminary spondylolisthesis, where one of the bones in your back slides forward over the bone below it. The two surgeries are called Transforaminal Lumbar Interbody Fusion (TLIF) and Posterolateral Fusion (PLF) alone.

The researchers looked at data from patients who had one of these surgeries between October 2010 and May 2021. They wanted to see which surgery was more successful in the long term, looking at things like whether patients had to have another operation, any complications, whether patients were readmitted to hospital, and how patients reported their own recovery and return to work.

Of the 546 people in the study, 373 had the TLIF surgery and 173 had the PLF surgery. The researchers found that those who had the TLIF surgery were less likely to need another operation compared to those who had the PLF surgery. However, they didn’t find any difference between the two surgeries in terms of complications, readmission rates or how patients rated their own recovery.

In simple terms, this research suggests that for people with this specific back condition, the TLIF surgery might be a better option because they’re less likely to need another operation later on.

FAQs

  1. What is degenerative luminary spondylolisthesis and what surgeries are used to treat it?
  2. According to the research, what are the benefits of TLIF surgery over PLF surgery for treating degenerative luminary spondylolisthesis?
  3. Did the research find any differences in complications, readmission rates, or patient-reported recovery between the TLIF and PLF surgeries?

Doctor’s Tip

Additionally, a doctor might advise a patient undergoing lumbar fusion surgery to follow post-operative care instructions carefully, including proper lifting techniques, avoiding high-impact activities, and attending physical therapy sessions to help with recovery and strengthen the back muscles. It’s also important for patients to maintain a healthy weight and practice good posture to prevent further strain on the back. Regular follow-up appointments with the doctor are essential to monitor progress and address any concerns or complications that may arise.

Suitable For

Patients who are typically recommended lumbar fusion surgery are those who have conditions such as degenerative lumbar spondylolisthesis, spinal stenosis, herniated discs, or other spinal deformities that have not responded to conservative treatments such as physical therapy, medications, or injections. These patients may be experiencing severe back pain, leg pain, numbness, weakness, or difficulty walking, and their symptoms are significantly impacting their quality of life. Lumbar fusion surgery is considered when other treatments have failed to provide relief and the patient’s symptoms are significantly affecting their daily activities and mobility.

Timeline

Before lumbar fusion:

  • Patient experiences chronic back pain, leg pain, and numbness
  • Patient undergoes diagnostic tests such as X-rays, MRI, and CT scans to determine the cause of their symptoms
  • Patient tries conservative treatments such as physical therapy, medications, and injections to manage their symptoms
  • If conservative treatments fail to provide relief, patient and their healthcare provider discuss surgical options such as lumbar fusion

After lumbar fusion:

  • Patient undergoes preoperative evaluation and preparation for surgery
  • Patient undergoes lumbar fusion surgery, which involves removing the damaged disc and fusing the affected vertebrae together
  • Patient stays in the hospital for a few days for recovery and monitoring
  • Patient undergoes postoperative physical therapy to help them regain strength and mobility
  • Patient follows up with their healthcare provider for monitoring and to address any postoperative complications or concerns
  • Patient gradually resumes normal activities and work, with the goal of improving their quality of life and reducing their pain and symptoms.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lumbar fusion include:

  1. What is the success rate of Transforaminal Lumbar Interbody Fusion (TLIF) compared to Posterolateral Fusion (PLF) for treating my specific condition?
  2. What are the potential risks and complications associated with each type of surgery?
  3. How long is the recovery time for each surgery, and what can I expect in terms of pain and mobility during the recovery process?
  4. Are there any specific criteria or factors that would make me a better candidate for one type of surgery over the other?
  5. Will I need physical therapy or rehabilitation after the surgery, and if so, for how long?
  6. What is the likelihood that I will need another operation in the future if I choose one type of surgery over the other?
  7. How soon can I expect to return to work or normal activities after the surgery?
  8. Are there any alternative treatment options to consider before deciding on lumbar fusion surgery?
  9. What is the long-term outlook for my condition if I choose to undergo lumbar fusion surgery?
  10. Can you provide me with any additional resources or information to help me make an informed decision about which surgery option is best for me?

Reference

Authors: Tang AR, Chanbour H, Steinle AM, Jonzzon S, Roth SG, Gardocki RJ, Stephens BF, Abtahi AM, Zuckerman SL. Journal: Neurosurgery. 2023 Jul 1;93(1):186-197. doi: 10.1227/neu.0000000000002402. Epub 2023 Feb 24. PMID: 36848669