title: [Are There Segmental Differences of Lumbar Spondylodesis? - Comparison of the Segments L IV/V and L V/S I in Patients with Transforaminal Lumbar Intercorporal Fusion (TLIF)].
abstract: BACKGROUND
  The aim of this study was to report surgical results with open TLIF (transforaminal lumbar intervertebral fusion) of segment L V/S I, in comparison with TLIF of segment L IV/V.
  
  
  METHODS
  60 patients with degenerative spine disease were operated with TLIF spondylodesis and followed up in a clinical and radiological study. 30 patients were operated in segment L IV/V (group 1) and another 30 in segment L V/S I (group 2). These patients were followed up 2 weeks and 12 months after surgery, by means of a clinical examination and questionnaires on pain (visual analogue scale) and quality of life (Oswestry score).
  
  
  RESULTS
  The rate of intra- and postoperative complications was 5 % in all 60 patients; the fusion rate was 100 %. In all patients, a 70 % improvement in back pain, leg pain and quality of life was achieved after 12 months. For leg pain and quality of life, a significantly better result was seen in group 1 than in group 2 two weeks after the operation. This may be explained by reversible dysaesthesias in 3 patients in group 2. In 2 patients in group 2, it was necessary to convert from TLIF to ALIF (anterior lumbar interbody fusion). Directly after the operation, the mean intervertebral height was 8.2 mm in group 1 and 7.3 mm in group 2, in comparison with 7.7 mm and 6.8 mm after one year, respectively.
  
  
  CONCLUSIONS
  In patients with contraction osteochondrosis in segment L V/S I, spondylodesis in segment L V/S I is - for anatomical reasons - more likely to be linked to reversible nerve irritations than with segment L IV/V. In some cases, conversion from TLIF on ALIF is necessary. In patients with degenerative spine disease, TLIF in segments L IV/V and L V/S I is absolutely accepted as a safe and up-to-date procedure.
authors.affiliation: Orthopädiezentrum Arabellapark München.
authors.forename: O
authors.initials: O
authors.lastname: Linhardt
authors.affiliation: Orthopädische Klinik für die Universität Regensburg, Bad Abbach.
authors.forename: J
authors.initials: J
authors.lastname: Grifka
authors.affiliation: Orthopädische Klinik für die Universität Regensburg, Bad Abbach.
authors.forename: A
authors.initials: A
authors.lastname: Benditz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012447:Sacrum / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D055035:Spinal Osteochondrosis / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome