DefinePK

Research Objective

To evaluate the midterm clinical and radiological outcomes of Transforaminal Lumbar Interbody Fusion (TLIF) in patients with single-level lumbar disc degeneration, focusing on pain relief, functional improvement, and complications.

Methodology

A retrospective cohort study involving 120 patients who underwent single-level TLIF for lumbar disc degeneration between 2018-2023 at Hayatabad Medical Complex, Peshawar. Inclusion criteria included MRI-confirmed single-level lumbar disc degeneration, failure of conservative treatment for at least 6 months, and undergoing TLIF during the study period. Data collected included preoperative and postoperative pain scores (VAS), Oswestry Disability Index (ODI), and radiological parameters. SPSS version 24 was used for analysis.

Methodology Flowchart

                        graph TD;
    A["Patient Selection & Inclusion Criteria Check"] --> B["Data Collection: Pre-op & Post-op VAS, ODI, Radiology"];
    B --> C["Data Analysis"];
    C --> D["Descriptive Statistics"];
    C --> E["Paired t-tests for VAS/ODI"];
    C --> F["Chi-square for Fusion Rates"];
    C --> G["Multivariate Regression for Predictors"];
    D --> H["Summarize Demographics & Characteristics"];
    E --> I["Assess Clinical Improvement"];
    F --> J["Determine Fusion Success"];
    G --> K["Identify Outcome Predictors"];
    H --> L["Report Results"];
    I --> L;
    J --> L;
    K --> L;
    L --> M["Discussion & Conclusion"];                    

Discussion

The study supports TLIF as an effective treatment for single-level lumbar disc degeneration, demonstrating significant symptom relief and functional improvement. The high fusion rate is consistent with literature. Adjacent segment disease remains a concern, necessitating further research into mitigation strategies. Patient selection based on preoperative disability and age is crucial for optimizing outcomes.

Key Findings

The mean follow-up period was 36 months. Statistically significant improvements were observed in both pain scores (p < 0.001) and ODI scores (p < 0.001). Fusion rates were high, with 92% of patients achieving solid fusion. Complications occurred in 15% of cases, with adjacent segment disease being the most common (8.3%). Higher preoperative ODI scores and older age were associated with less favorable postoperative outcomes.

Conclusion

TLIF provides significant pain relief and functional improvement with high fusion rates in patients with single-level lumbar disc degeneration at midterm follow-up. It has an acceptable complication profile, though adjacent segment disease requires attention. Patient selection and surgical technique are key to successful outcomes.

Fact Check

1. Fusion Rate: The study reports a high fusion rate of 92% (110 out of 120 patients) at the final follow-up.
2. Complication Incidence: Complications were observed in 15% of the cases.
3. Pain Score Improvement: Mean VAS scores for back pain decreased from 7.8 preoperatively to 2.3 postoperatively (p < 0.001).

Mind Map