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Posterior Lumbar Fixation Surgeries, Indications and Approaches (Posterolateral Fixation, PLIF and TLIF) Clinical Perspective

Received: 17 May 2021    Accepted: 19 June 2021    Published: 25 June 2021
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Abstract

Background: Posterior lumbar fixation surgery is common procedure associated with lumbar fusion with different technique. The most frequent type of spine fusion is lumbar spine fusion, which can be done for a variety of reasons. There are two main techniques for lumbar spine fusion, posterolateral fusion and lumbar interbody fusion. This review aims to summarise, evaluate systematic reviews and analyze the therapeutic efficacy and outcome of posterior lumbar fixation surgeries and lumbar fusion including posterolateral fusion, PLIF and TLIF for most common diagnoses. In cases of recurrent lumbar disc herniation, there is no evidence that spine fusion has therapeutic advantage over repeated discectomy. There was no difference in the rates of re-operation between the two surgical procedures. According to lumbar fracture, we found no superiority in clinical benefit, system failure rate and other radiological parameters of arthrodesis over fixation only, in thoracolumbar burst fracture. The no-fusion group had much less surgical time and blood loss. Results of review for patients receiving fusion surgery for spondylolisthesis show that, In terms of attaining radiographic fusion, TLIF is superior to PLF without any observable increased risk for infection. However, There is very little evidence, that TLIF is better than PLF for attaining clinical improvement. If surgical intervention for spondylodiscitis is needed, less invasive surgical approaches (single-stage anterior or posterior fusion techniques) are strongly recommended, since they can have a better therapeutic outcome than more complex mixed anterior–posterior procedures. For more accurate evaluation of the efficacy of spinal fusion surgery on all indications, more evidence is required.

Published in International Journal of Neurosurgery (Volume 5, Issue 1)
DOI 10.11648/j.ijn.20210501.21
Page(s) 47-51
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Spine Fusion, Lumbar Fixation, Back Pain, Surgery

References
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[14] Diniz, J. M., & Botelho, R. V. (2017). Is fusion necessary for thoracolumbar burst fracture treated with spinal fixation? A systematic review and meta-analysis. Journal of Neurosurgery: Spine, 27 (5), 584-592.‏
[15] Palmisani M, Gasbarrini A, Brodano GB, De Iure F, Cappuccio M, Boriani L, et al: Minimally invasive percutaneous fixation in the treatment of thoracic and lumbar spine fractures. Eur Spine J 18 (Suppl 1): 71–74, 2009.
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  • APA Style

    Adel Nabih Mohamed, Ahmed Faisal Toubar, Muhamed Abdelmoez, Omar Elfarouk. (2021). Posterior Lumbar Fixation Surgeries, Indications and Approaches (Posterolateral Fixation, PLIF and TLIF) Clinical Perspective. International Journal of Neurosurgery, 5(1), 47-51. https://doi.org/10.11648/j.ijn.20210501.21

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    ACS Style

    Adel Nabih Mohamed; Ahmed Faisal Toubar; Muhamed Abdelmoez; Omar Elfarouk. Posterior Lumbar Fixation Surgeries, Indications and Approaches (Posterolateral Fixation, PLIF and TLIF) Clinical Perspective. Int. J. Neurosurg. 2021, 5(1), 47-51. doi: 10.11648/j.ijn.20210501.21

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    AMA Style

    Adel Nabih Mohamed, Ahmed Faisal Toubar, Muhamed Abdelmoez, Omar Elfarouk. Posterior Lumbar Fixation Surgeries, Indications and Approaches (Posterolateral Fixation, PLIF and TLIF) Clinical Perspective. Int J Neurosurg. 2021;5(1):47-51. doi: 10.11648/j.ijn.20210501.21

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  • @article{10.11648/j.ijn.20210501.21,
      author = {Adel Nabih Mohamed and Ahmed Faisal Toubar and Muhamed Abdelmoez and Omar Elfarouk},
      title = {Posterior Lumbar Fixation Surgeries, Indications and Approaches (Posterolateral Fixation, PLIF and TLIF) Clinical Perspective},
      journal = {International Journal of Neurosurgery},
      volume = {5},
      number = {1},
      pages = {47-51},
      doi = {10.11648/j.ijn.20210501.21},
      url = {https://doi.org/10.11648/j.ijn.20210501.21},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20210501.21},
      abstract = {Background: Posterior lumbar fixation surgery is common procedure associated with lumbar fusion with different technique. The most frequent type of spine fusion is lumbar spine fusion, which can be done for a variety of reasons. There are two main techniques for lumbar spine fusion, posterolateral fusion and lumbar interbody fusion. This review aims to summarise, evaluate systematic reviews and analyze the therapeutic efficacy and outcome of posterior lumbar fixation surgeries and lumbar fusion including posterolateral fusion, PLIF and TLIF for most common diagnoses. In cases of recurrent lumbar disc herniation, there is no evidence that spine fusion has therapeutic advantage over repeated discectomy. There was no difference in the rates of re-operation between the two surgical procedures. According to lumbar fracture, we found no superiority in clinical benefit, system failure rate and other radiological parameters of arthrodesis over fixation only, in thoracolumbar burst fracture. The no-fusion group had much less surgical time and blood loss. Results of review for patients receiving fusion surgery for spondylolisthesis show that, In terms of attaining radiographic fusion, TLIF is superior to PLF without any observable increased risk for infection. However, There is very little evidence, that TLIF is better than PLF for attaining clinical improvement. If surgical intervention for spondylodiscitis is needed, less invasive surgical approaches (single-stage anterior or posterior fusion techniques) are strongly recommended, since they can have a better therapeutic outcome than more complex mixed anterior–posterior procedures. For more accurate evaluation of the efficacy of spinal fusion surgery on all indications, more evidence is required.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Posterior Lumbar Fixation Surgeries, Indications and Approaches (Posterolateral Fixation, PLIF and TLIF) Clinical Perspective
    AU  - Adel Nabih Mohamed
    AU  - Ahmed Faisal Toubar
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    AB  - Background: Posterior lumbar fixation surgery is common procedure associated with lumbar fusion with different technique. The most frequent type of spine fusion is lumbar spine fusion, which can be done for a variety of reasons. There are two main techniques for lumbar spine fusion, posterolateral fusion and lumbar interbody fusion. This review aims to summarise, evaluate systematic reviews and analyze the therapeutic efficacy and outcome of posterior lumbar fixation surgeries and lumbar fusion including posterolateral fusion, PLIF and TLIF for most common diagnoses. In cases of recurrent lumbar disc herniation, there is no evidence that spine fusion has therapeutic advantage over repeated discectomy. There was no difference in the rates of re-operation between the two surgical procedures. According to lumbar fracture, we found no superiority in clinical benefit, system failure rate and other radiological parameters of arthrodesis over fixation only, in thoracolumbar burst fracture. The no-fusion group had much less surgical time and blood loss. Results of review for patients receiving fusion surgery for spondylolisthesis show that, In terms of attaining radiographic fusion, TLIF is superior to PLF without any observable increased risk for infection. However, There is very little evidence, that TLIF is better than PLF for attaining clinical improvement. If surgical intervention for spondylodiscitis is needed, less invasive surgical approaches (single-stage anterior or posterior fusion techniques) are strongly recommended, since they can have a better therapeutic outcome than more complex mixed anterior–posterior procedures. For more accurate evaluation of the efficacy of spinal fusion surgery on all indications, more evidence is required.
    VL  - 5
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Author Information
  • Neurosurgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

  • Neurosurgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

  • Neurosurgery Department, Alahrar Teaching Hospital, Zagazig, Egypt

  • Neurosurgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

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