Year: 2025 | Month: March | Volume: 12 | Issue: 3 | Pages: 25-31
DOI: https://doi.org/10.52403/ijrr.20250305
Comparison of Clinical and Functional Outcomes of Posterior Lumbar Interbody Fusion (PLIF), Lateral Lumbar Interbody Fusion (LLIF) and Posterolateral Fusion (PLIF) on Degenerative Spine Disease: A Systematic Review and Meta-Analysis
Ignatius Angga Rusdianto1, Kenny Gozal2, I Gusti Lanang Ngurah Agung Artha Wiguna2
1Resident, Dept. Orthopaedic & Traumatology, Prof IGNG Ngoerah General Hospital, Udayana University, Bali, Indonesia
2Orthopaedic Surgeon, Dept. Orthopaedic & Traumatology, Prof IGNG Ngoerah General Hospital, Udayana University, Bali, Indonesia
Corresponding Author: Ignatius Angga Rusdianto
ABSTRACT
Introduction: Posterolateral lumbar fusion (PLF) was once the predominant surgical approach, but its lack of anterior support, which affects spinal biomechanics, has limited its use. In response, the interbody approach, including posterior lumbar interbody fusion (PLIF) and lateral lumbar interbody fusion (LLIF), has been suggested as superior to the traditional method. the superiority of PLIF or LLIF over PLF remains a subject of debate
Methods: A systematic search using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was carried out to identify studies that were considered to be included in this meta-analysis review from 2015 to 2020. The outcomes assessed using forest plot were Visual Analogue Score (VAS) and Oswestry Disability Index (ODI) and this study systematically assessed clinical and radiological outcome
Results: This meta-analysis included a total number of 3377 patients with 1740 patients undergoing interbody fusion and 1637 patients undergoing PLF. The follow-up period was nearly similar between studies, ranging from one to two years post-operatively. The patient’s age ranged from 50-85 years old.
Discussion: Meta-analyses found no significant differences in postoperative visual analog score (VAS) or Oswestry Disability Index (ODI) between PLF and interbody fusion groups. Variations in intraoperative blood loss between interbody and lateral fusion procedures are noted, potentially impacting surgical outcomes and complication rates, including neurological deficits and infections associated with interbody fusion techniques.
Conclusion: VAS and ODI outcomes were not significantly different between PLF and interbody fusion. However, PLF might provide better Cobb angle correction, meanwhile other outcome aspects were observed to be similar between the two groups.
Keywords: posterolateral lumbar fusion, interbody fusion, visual analogue score, oswestry disability index.
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