BIOMECHANICAL COMPARISON OF POSTERIOR AND TRANSFORAMINAL INTERBODY FUSION CONSTRUCTS FOR THE DEGENERATIVE LUMBAR SPINE

摘要

Posterior lumbar interbody fusion (PLIF) is an established technique that allows circumferential fusion of lumbar spine through a single incision. A variation of PLIF called transforaminal lumbar interbody fusion (TLIF) uses a posterior approach to the spine but accesses the disc space via a path that runs through the far lateral portion of the vertebral foramen. TLIF provides the surgeon with a fusion procedure that reduces many of the risks and limitations associated with PLIF. Like PLIF, TLIF is easily enhanced when combined with posterolateral fusion (PLF) and instrumentation. TLIF offers an advantage in that it is usually done via a unilateral approach preserving the facet joint and the interlaminar surface on the contralateral side. It minimizes soft tissue stripping and neural element retraction compared to PLIF, while providing a single-stage circumferential fusion. This study compared the biomechanical performance of these two constructs in flexion, extension, and lateral bending under physiologic compressive preloads.