Application Of TLIF And PLIF In Monosegmental Lumbar Interbody Fusion

Objective:To analyze the advantages and disadvantages of PLIF and TLIF in mono-segmental lumber interbody fusion for helping to select a more reasonable surgery method.Method:46 cases treated with PLIF in China-Japan union hospital of Jilin University from 1997 to 2007 and 43 cases treated with TLIF in Karolinska University Hospital Huddinge from 2004 to 2007 are reviewed to compare the blood loss, surgery time and other complications during and after operation. The factors which contribute to the differences between the 2 methods are analyzed also.Result:The average blood loss of TLIF is 502±241 ml, which is significantly less than 848±429 ml of PLIF(p<0.01). the average time of surgery of TLIF is 178±40 minutes, which is significantly less than 225±64 minutes of PLIF(p<0.01). complications were found in 13 of 46 cases(28%) treated with PLIF among which 4 cases(9%) were of nerve damage. complications were found in 6 of 43 cases(13%) treated with PLIF among which 1 case(2%) were of nerve damage.Conclusion : the blood loss, the surgery time and the complications of TLIF is significantly less than PLIF. TLIF is more suitable for upper intervertebral surgery and the reoperation in posterior approach to lumbar.interspinale ligament,supraspinale ligament , flavum ligamentum , lamin and other posterior stable structures can be reserved, which is beneficial to lumbar stability. The intervertebral bone graft during PLIF should not be positioned laterally to avoid the damage of anterior longitudinal blood sinusoid.