Tesi etd-05022023-142543 |
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Tipo di tesi
Tesi di laurea magistrale LM6
Autore
CASTELLANO, LUCA
Indirizzo email
l.castellano@studenti.unipi.it, castellanoluca@yahoo.com
URN
etd-05022023-142543
Titolo
Comparison between Transforaminal lumbar interbody fusion and Posterior lumbar interbody fusion in lumbosacral spondylolisthesis: a study of 250 patients
Dipartimento
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
MEDICINA E CHIRURGIA
Relatori
relatore Perrini, Paolo
Parole chiave
- TLIF. PLIF. Interbody fusion. Spondylolisthesis.
Data inizio appello
23/05/2023
Consultabilità
Tesi non consultabile
Riassunto
Background context: interbody fusion is the gold standard in the treatment of lumbosacral spondylolisthesis. Transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF) have been widely and successfully used for many years.
Purpose: The objective of this study was to compare TLIF and PLIF in order to compare the clinical and radiological results.
Methods: we collected 250 consecutive patients operated on using PLIF (125 cases) and TLIF (125 cases), in a period of time ranging from 2010 to 2021. We evaluated pre and post-operative ODI and VAS, number of stabilized levels, duration of the operation, complications, pre and postoperative segmental lordotic angle.
Results: In patients treated with PLIF, mean postoperative ODI was 5.46 ± 1.75 (P=0.05) and mean postoperative VAS was 1.65 ± 0.43 (P=0.05), while in patients treated with TLIF mean postoperative ODI was 3.90 ± 1.35 (P=0.05) and mean postoperative VAS was 1.41 ± 0.39 (P=0.05). For PLIF, the mean operative time was 220.12 minutes ± 13.32 minutes (P=0.05), ranging from 120 minutes to 420 minutes. For TLIF, the mean operative time was 221.28 minutes ± 10.51 minutes (P=0.05), ranging from 100 minutes to 450 minutes. When we consider only 2020 and 2021, the mean operative time is 207,44 ± 9,99 for TLIF. In PLIF surgeries, the complication rate was 14.4%, while in TLIF surgeries the complication rate was 10.4%. PLIF mean Segmental Lordotic Angle (SLA) improvement was 1,42° ± 1,21° (P=0,005), while TLIF mean SLA improvement was 2,67° ± 0,98° (P=0,005).
Conclusions: both PLIF and TLIF are two effective surgical option for fusion in spondylolisthesis. TLIF and PLIF have similar clinical outcomes although TLIF has a lower complication rate. The operative time is similar, but if we consider only the years 2020-2021, the TLIF has significant shorter operating times. TLIF has significant better ability to restore segmental lordosis.
Keywords: spondylolisthesis, PLIF, TLIF, spinal fusion, ODI, VAS, lordosis, fusion rate, operation time, complications.
Purpose: The objective of this study was to compare TLIF and PLIF in order to compare the clinical and radiological results.
Methods: we collected 250 consecutive patients operated on using PLIF (125 cases) and TLIF (125 cases), in a period of time ranging from 2010 to 2021. We evaluated pre and post-operative ODI and VAS, number of stabilized levels, duration of the operation, complications, pre and postoperative segmental lordotic angle.
Results: In patients treated with PLIF, mean postoperative ODI was 5.46 ± 1.75 (P=0.05) and mean postoperative VAS was 1.65 ± 0.43 (P=0.05), while in patients treated with TLIF mean postoperative ODI was 3.90 ± 1.35 (P=0.05) and mean postoperative VAS was 1.41 ± 0.39 (P=0.05). For PLIF, the mean operative time was 220.12 minutes ± 13.32 minutes (P=0.05), ranging from 120 minutes to 420 minutes. For TLIF, the mean operative time was 221.28 minutes ± 10.51 minutes (P=0.05), ranging from 100 minutes to 450 minutes. When we consider only 2020 and 2021, the mean operative time is 207,44 ± 9,99 for TLIF. In PLIF surgeries, the complication rate was 14.4%, while in TLIF surgeries the complication rate was 10.4%. PLIF mean Segmental Lordotic Angle (SLA) improvement was 1,42° ± 1,21° (P=0,005), while TLIF mean SLA improvement was 2,67° ± 0,98° (P=0,005).
Conclusions: both PLIF and TLIF are two effective surgical option for fusion in spondylolisthesis. TLIF and PLIF have similar clinical outcomes although TLIF has a lower complication rate. The operative time is similar, but if we consider only the years 2020-2021, the TLIF has significant shorter operating times. TLIF has significant better ability to restore segmental lordosis.
Keywords: spondylolisthesis, PLIF, TLIF, spinal fusion, ODI, VAS, lordosis, fusion rate, operation time, complications.
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