title: Fueling the debate: Are outcomes better after posterior lumbar interbody fusion (PLIF) or after posterolateral fusion (PLF) in adult patients with low-grade adult isthmic spondylolisthesis?
abstract: METHODS
  Retrospective cohort study.
  
  
  OBJECTIVE
  Do more adult patients affected by low grade isthmic spondylolisthesis have significant clinical and radiological improvement following posterior lumbar interbody fusion (PLIF) than those who receive posterolateral fusion (PLF)?
  
  
  METHODS
  One hundred and fourteen patients affected by adult low grade isthmic spondylolisthesis, treated with posterior lumbar interbody fusion or posterolateral fusion, were reviewed. Clinical outcome was assessed by means of the questionnaires ODI, RMDQ and VAS. Radiographic evaluation included CT, MRI, and x-rays. The results were analyzed using the Student t-test.
  
  
  RESULTS
  The two groups were similar with respect to demographic and surgical characteristics. At an average follow-up of 62.1 months, 71 patients were completely reviewed. Mean ODI, RMDQ and VAS scores didn't show statistically significant differences. Fusion rate was similar between the two groups (97% in PLIF group, 95% in PLF group). Major complications occurred in 5 of 71 patients reviewed (7%): one in the PLIF group (3.6%), four in the PLF group (9.3%). Pseudarthrosis occurred in one case in the PLIF group (3,6%) and in two cases in PLF group (4.6%).
  
  
  CONCLUSIONS
  In our series, there does not appear to be a clear advantage of posterior lumbar interbody fusion (PLIF) over posterolateral fusion (PLF) in terms of clinical and radiological outcome for treatment of adult low grade isthmic spondylolisthesis.
authors.affiliation: Istituti Ortopedici Rizzoli, Oncologic and Degenerative Spine Department, Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Barbanti Bròdano
authors.forename: F
authors.initials: F
authors.lastname: Lolli
authors.forename: K
authors.initials: K
authors.lastname: Martikos
authors.forename: A
authors.initials: A
authors.lastname: Gasbarrini
authors.forename: S
authors.initials: S
authors.lastname: Bandiera
authors.forename: T
authors.initials: T
authors.lastname: Greggi
authors.forename: P
authors.initials: P
authors.lastname: Parisini
authors.forename: S
authors.initials: S
authors.lastname: Boriani
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