title: Addition of TLIF does not improve outcome over standard posterior instrumented fusion. 5-10 years long-term Follow-up: results from a RCT.
abstract: The use of inter-body device in lumbar fusions has been difficult to validate, only few long-term RCT are available.
  
  
  
  Between 2003 and 2005, 100 patients entered a RCT between transforaminal lumbar inter-body fusion (TLIF) or posterolateral instrumented lumbar fusion (PLF). The patients suffered from LBP due to segmental instability, disc degeneration, former disc herniation, spondylolisthesis Meyerding grade <2. Functional outcome parameters as Dallas pain questionnaire (DPQ), SF-36, low back pain questionnaire (LBRS), Oswestry disability index (ODI) were registered prospectively, and after 5-10 years.
  
  
  
  Follow-up reached 93 % of available, (94 %, 44 in the PLF's and 92 %, 44 in the TLIF group p = 0.76). Mean follow-up was 8.6 years (5-10 years). Mean age at follow-up was 59 years (34-76 years p = 0.19). Reoperation rate in a long-term perspective was equal among groups 14 %, each p = 0.24. Back pain was 3.8 (mean) (Scale 0-10), TLIF (3.65) PLF (3.97) p = 0.62, leg pain 2.68 (mean) (Scale 0-10) 2.90 (TLIF) and 2.48 (PLF) p = 0.34. No difference in functional outcome between groups p = 0.93. Overall, global satisfaction with the primary intervention at 8.6 year was 76 % (75 % TLIF and 77 % PLF) p = 0.85.
  
  
  
  In a long-term perspective, patients with TLIF's did not experience better outcome scores.
authors.affiliation: Department of Orthopedics, Spine Section E, Aarhus University Hospital, Aarhus University, Nørrebrogade 44, 8000, Aarhus C, Denmark. krishoey@rm.dk.
authors.forename: Kristian
authors.initials: K
authors.lastname: Høy
authors.affiliation: Department of Orthopedics, Spine Section E, Aarhus University Hospital, Aarhus University, Nørrebrogade 44, 8000, Aarhus C, Denmark.
authors.forename: Kamilla
authors.initials: K
authors.lastname: Truong
authors.affiliation: Department of Orthopedics, Spine Section E, Aarhus University Hospital, Aarhus University, Nørrebrogade 44, 8000, Aarhus C, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Andersen
authors.affiliation: Department of Orthopedics, Spine Section E, Aarhus University Hospital, Aarhus University, Nørrebrogade 44, 8000, Aarhus C, Denmark.
authors.forename: Cody
authors.initials: C
authors.lastname: Bünger
mesh_terms: D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D013123:Spinal Fusion / Q000379:methods*
keywords: Functional outcome; Long-term; Posterolateral instrumented lumbar fusion (PLF); Randomized clinical trial (RCT); Transforaminal lumbar inter-body fusion (TLIF)