Posterior lumbar interbody fusion versus intertransverse fusion in the treatment of lumbar spondylolisthesis.

Abstract

To compare 2 methods of fusion in the treatment of lumbar spondylolisthesis: posterior lumbar interbody fusion (PLIF) and intertransverse fusion (ITF). 20 patients with lumbar spondylolisthesis were randomly allocated to one of 2 groups: decompression, posterior instrumentation, and PLIF (n=10) or decompression, posterior instrumentation, and ITF (n=10). The Oswestry low back pain disability questionnaire was used for clinical assessment. Radiography was performed preoperatively and postoperatively to assess the reduction of spondylolisthesis or slip. In the PLIF and ITF groups, 87.5% and 100% had a satisfactory clinical result, and 48% and 39% had reduced spondylolisthesis, respectively. Both had a fusion rate of 100%. PLIF showed better reduction of spondylolisthesis, although ITF achieved a better subjective and clinical outcome. Morbidity and complications are much higher following PLIF than ITF. ITF is recommended because of the simplicity of the procedure, lower complication rate, and good clinical and radiological results.