title: An RCT study comparing the clinical and radiological outcomes with the use of PLIF or TLIF after instrumented reduction in adult isthmic spondylolisthesis.
abstract: We prospectively compared posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) used in adult isthmic spondylolisthesis (IS) after surgical reduction with pedicle screws.
  
  
  
  Between January 2009 and December 2010, 66 adult patients with single-level IS were randomly assigned to two groups treated using the PLIF technique (PLIF group, n = 34) and the TLIF technique (TLIF group, n = 32). Both groups were followed up for an average of 30.5 months (range 24-48 months). Clinical outcomes were assessed using the visual analog scale (VAS), Oswestry disability index (ODI) and Japanese orthopedic association (JOA) scores. Radiographic outcomes included percentage of vertebral slippage, focal lordosis and disk height. Clinical and radiographic outcomes were compared between the two groups.
  
  
  
  The average operative time and blood loss during surgery were significantly more in PLIF group than in TLIF group. Spondylolisthesis, disk height and focal lordosis were significantly improved postoperatively in both groups. There was no obvious difference in clinical outcomes, as assessed using the VAS, ODI and JOA scores, and radiographic outcomes. In PLIF group, there were two cases of neuropathic pain after surgery.
  
  
  
  After instrumented reduction of adult IS, either PLIF or TLIF can provide good clinical and radiological outcomes. With a single cage, TLIF was superior to PLIF in terms of surgical time and blood loss, but these differences may not be clinically relevant.
authors.affiliation: Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Er-Zhu
authors.initials: EZ
authors.lastname: Yang
authors.affiliation: Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Jian-Guang
authors.initials: JG
authors.lastname: Xu
authors.affiliation: Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Xiao-Kang
authors.initials: XK
authors.lastname: Liu
authors.affiliation: Department of Orthopedics, 101st Hospital of PLA, Wuxi, Jiangsu, China.
authors.forename: Gen-Yang
authors.initials: GY
authors.lastname: Jin
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Wenzhen
authors.initials: W
authors.lastname: Xiao
authors.affiliation: Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Bing-Fang
authors.initials: BF
authors.lastname: Zeng
authors.affiliation: Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China. xf909@tom.com.
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Lian
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D065289:Pedicle Screws; D011446:Prospective Studies; D013123:Spinal Fusion / Q000379:methods*; D013168:Spondylolisthesis / Q000601:surgery*; D055815:Young Adult
keywords: Isthmic spondylolisthesis; PLIF; Pedicle screws; Surgical reduction; TLIF