Transforaminal versus anterior lumbar interbody fusion in long deformity constructs: a matched cohort analysis.

摘要: STUDY DESIGN Prospectively enrolled, retrospectively analyzed matched cohort analysis. OBJECTIVE Evaluate the relative merits of transforaminal lumbar interbody fusion (TLIF) and anterior (ALIF) when performed in long deformity constructs. SUMMARY OF BACKGROUND DATA Interbody is frequently used at caudal levels long-segment spinal instrumentation constructs to protect sacral implants enhance rates. However, there a paucity literature regarding which technique more efficacious. METHODS Forty-two patients who underwent TLIF 42 ALIF were with respect age, sex, comorbidities, curve magnitude, length, ALIF/TLIF level. Radiographs clinical outcomes compared minimum 2-year follow-up. RESULTS Age averaged 54.0 years instrumented vertebrae 13.6. TLIFs had less operative time (481 vs. 595 min, P = 0.0007), but greater blood loss (2011 1281 mL, 0.0002). Overall complications (TLIF, 12/42 ALIF, 15/42) neurological 4/42 3/42) did not differ. One pseudarthrosis occurred an level, none levels. Patients began lower SRS scores showed improvement (44.4 70.7 58.6 70.6, 0.0043). ODI both groups improved similarly. Regionally, ALIFs engendered lordosis than L3-S1 (gain 6.9° -2.6°, < 0.0001) T12-S1 11.5° 7.9°, 0.29). Locally, created L4-L5 5.6° -1.7°, L5-S1 2.5° -1.4°, 0.022), L3-L4 5.3° 4.0°, 0.65). obtained correction anteroposterior Cobb angles (reduction 22.4° 9.9°, lumbosacral curves 10.3° 3.4°, 0.0001). CONCLUSION Spinal surgery rather resulted shorter no difference complication provided segmental lordosis, whereas afforded better scoliotic curves.