Transforaminal Lumbar Interbody Fusion: Does it Affect Lumbar Lordosis and Disc Height Really?

Abstract Background: Measurement of lumbar lordosis (Cobb's angle) and disc height in cases of single level lumbar fixation operated by posterolateral fixation with transforaminal inter-body fusion and compare them with traditional posterolateral fixation without cage insertion. Aim of Study: To determine if the usage of transforaminal interbody fusion would affect both lumbar lordosis and disc height or not. Patients and Methods: The present study retrospectively was done for 40 patients who underwent single level lumbar fixationin Cairo and Fayoum University Hospitals, between January 2019 and December 2020. The patients were dividedin two groups 20 in each, group A in which patients operatedupon by transforaminal interbody fusion (TLIF) together with transpedicular screws and group B in which patients operated upon by posterolateral fixation with transpedicular screws without cage insertion. In this study, the disc height and lumbar lordosis variations were evaluated by analysing spinal radiographs preoperatively, postoperatively and at 6 months follow-up. Results: In group A, there was a statistically significant increase in the mean of disc height immediately postoperative, then decrease after 6 months follow-up with p-value <0.05. In addition, there was a statistically significant increase in themean of lumbar lordosis immediately postoperative with p-value <0.05, but no significant change after 6 months follow-up with p-value >0.05. In group B there was no statistically significant changeinthemean of disc height immediately postoperative, but there was a statistically significant increase after 6 months follow-up with p-value <0.05. Regarding lumbar lordosis, there is no statistically significant change in the mean of lumber lordosis postoperatively with p-value >0.05. Conclusion: Transpedicular fixation with transforaminal interbody fusion (TLIF) shows statistically significant increase in disc height and lumbar lordosis compared to posterolateral fixation without cage insertion.