Unilateral Transforaminal Posterior Lumbar Interbody Fusion.

Several lumbar interbody fusion techniques were described to eliminate motion and restore physiological lordosis in case of severe spinal stenosis, degenerative scoliosis, spondilolistesis or instability. The aim of this scientific exhibit is to describe the unilateral transforaminal posterior lumbar interbody fusion (UTPLIF) in a series of 54 patients. Clinical evaluation of pain associated with MRI, CT-scan and plain films of the lumbar spine were used to decide the extension of the posterior stabilization, the levels and the side of interbody fusion. Twelve patients were operated at 1 level, 27 at 2 levels, 15 at 3 levels or more. Through a standard posterior approach to the lumbar spine, pedicle fixation was performed and the segment was placed in distraction. Through a unilateral transforaminal approach discectomy was performed and a PEEK (poli-ether-ether-ketone) cage filled with autologous bone graft was implanted and placed in compression by pedicle fixation with the aim of restore the physiological lordosis maintaining open the neuroforamina. Mean follow-up time was 5 years. No general complications were observed. Three dural tears occurred. Preoperative segmental lordosis was 10°±7 and at follow-up was 19°±8 (p=0,05). Mean VAS score was 7.5±3 preoperatively and 2.9±2 (p<0.005) at follow-up. Thirty patients were scored as excellent, 17 good, 5 fair and 2 poor. UTPLIF is an effective procedure for the treatment of severe lumbar stenosis and instability, consequent of different spinal disorders. A precise evaluation of clinical symptoms and a strict correlation with imaging, is crucial in order to plan a correct surgical treatment.