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Comparison of Unilateral versus Bilateral Instrumented Transforaminal Lumbar Interbody Fusion in Lumbar Degenerative Diseases: A Minimum of 5-Year Follow-Up
Park, S.C.; Bae, J.S.; Jung, S.O.; Sung, K.-H.; Chung, H.-J. Comparison of Unilateral versus Bilateral Instrumented Transforaminal Lumbar Interbody Fusion in Lumbar Degenerative Diseases: A Minimum of 5-Year Follow-Up. Medicina2023, 59, 1898.
Park, S.C.; Bae, J.S.; Jung, S.O.; Sung, K.-H.; Chung, H.-J. Comparison of Unilateral versus Bilateral Instrumented Transforaminal Lumbar Interbody Fusion in Lumbar Degenerative Diseases: A Minimum of 5-Year Follow-Up. Medicina 2023, 59, 1898.
Park, S.C.; Bae, J.S.; Jung, S.O.; Sung, K.-H.; Chung, H.-J. Comparison of Unilateral versus Bilateral Instrumented Transforaminal Lumbar Interbody Fusion in Lumbar Degenerative Diseases: A Minimum of 5-Year Follow-Up. Medicina2023, 59, 1898.
Park, S.C.; Bae, J.S.; Jung, S.O.; Sung, K.-H.; Chung, H.-J. Comparison of Unilateral versus Bilateral Instrumented Transforaminal Lumbar Interbody Fusion in Lumbar Degenerative Diseases: A Minimum of 5-Year Follow-Up. Medicina 2023, 59, 1898.
Abstract
Background and Objective: There is a paucity of literature comparing unilateral instrumented transforaminal lumbar interbody fusion (UITLIF) with bilateral instrumented TLIF (BITLIF) regarding radiological alignment, including the coronal balance, even though UITLIF might have asymmetric characteristics in the coronal plane. This retrospective study aimed to compare the clinical and long-term radiological outcomes of 1-level UITLIF and BITLIF in lumbar degenerative diseases (LDD). Materials and Methods: Patients who underwent 1-level UITLIF with two rectangular polyetheretherketone (PEEK) cages or BITLIF with ≥ 5 years of follow-up at a single hospital were included. We compared the clinical and radiological outcomes between the UITLIF and BITLIF. Results: In total, 63 and 111 patients who underwent UITLIF and BITLIF, respectively, were enrolled. The median follow-up was 85.55 months (range: 60–130). The UITLIF group had a significantly shorter operation time (185.0 [170.0–210.0] vs. 225.0 [200.0–265.0], p < 0.001) and lower estimated blood loss (300.0 [250.0–500.0] vs. 550.0 [400.0–800.0], p < 0.001) than BITLIF group. Regarding the clinical outcomes, there were no significant differences in the intermittent claudication score (p = 0.495) and Kirkaldy–Willis criteria (p = 0.707) at 1 year postoperatively. The interval changes of the local coronal Cobb angle at the index level, L1-S1 lordotic angle, and coronal off-balance from the immediate postoperative radiograph to the last follow-up were not significantly different (p = 0.687, p = 0.701, and p = 0.367, respectively). Conclusion: UITLIF with two rectangular PEEK cages is a viable option for providing comparable clinical outcomes and radiological longevity to BITLIF in 1-level LDD. In addition, UITLIF has advantages over BITLIF in terms of operative time and blood loss.
Medicine and Pharmacology, Orthopedics and Sports Medicine
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