title: Two-year outcomes of transforaminal lumbar interbody fusion.
abstract: OBJECTIVE
  To evaluate the outcomes, fusion rates, complications, and adjacent segment degeneration associated with transforaminal lumbar interbody fusion (TLIF).
  
  
  METHODS
  32 men and 80 women aged 15 to 85 (mean, 57) years underwent 141 fusions (84 one-level, 27 2-level, and one 3-level) and were followed up for 24 to 76 (mean, 33) months. 92% of the patients had degenerative lumbar disease, 15 of whom had had previous lumbar surgery. Radiographic and clinical outcomes were assessed at 2 years. The short-form 36 (SF-36) health survey, visual analogue scale (VAS) for pain, and the modified North American Spine Society (NASS) Low Back Pain Outcome Instrument were used.
  
  
  RESULTS
  Of the 141 levels fused, 110 (78%) were fused with remodelling and trabeculae (grade I), and 31 (22%) had intact grafts but were not fully incorporated (grade II). No patient had pseudoarthroses (grade III or IV). For one-level fusions, poorer radiological fusion grades correlated with higher VAS scores for pain (p<0.01). All components of the SF-36, the VAS scores for pain, and the NASS scores improved significantly after TLIF (p<0.01), except for general health in the SF-36 (p=0.59). Improvement from postoperative 6 months to 2 years was not significant, except for physical function (p<0.01) and role function (physical) [p=0.01] in the SF-36. Two years after TLIF, 50% of the patients reported returning to full function, whereas 72% were satisfied. 26 (23%) of the patients had adjacent segment degeneration, but only 4 of them were symptomatic.
  
  
  CONCLUSIONS
  TLIF is a safe and effective treatment for degenerative lumbar diseases.
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
authors.forename: Seng Yew
authors.initials: SY
authors.lastname: Poh
authors.forename: Wai Mun
authors.initials: WM
authors.lastname: Yue
authors.forename: Li-Tat John
authors.initials: LT
authors.lastname: Chen
authors.forename: Chang-Ming
authors.initials: CM
authors.lastname: Guo
authors.forename: William
authors.initials: W
authors.lastname: Yeo
authors.forename: Seang-Beng
authors.initials: SB
authors.lastname: Tan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications / Q000453:epidemiology; D013123:Spinal Fusion / Q000009:adverse effects; D013168:Spondylolisthesis / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult