ALIF Versus TLIF for L5-S1 Isthmic Spondylolisthesis: ALIF Demonstrates Superior Segmental and Regional Radiographic Outcomes and Clinical Improvements Across More Patient-reported Outcome Measures Domains

Study Design. Retrospective cohort study. Objective. The purpose of this study was to compare segmental and regional radiographic parameters between anterior interbody fusion (ALIF) and posterior interbody fusion (TLIF) for treatment of L5-S1 isthmic spondylolisthesis, and to assess for changes in these parameters over time. Secondarily, we sought to compare clinical outcomes via patient-reported outcome measures (PROMs) between techniques and within groups over time. Summary of Background Data. Isthmic spondylolistheses are frequently treated with interbody fusion via ALIF or TLIF approaches. Robust comparisons of radiographic and clinical outcomes are lacking. Methods. We reviewed pre- and postoperative radiographs as well as Patient-Reported Outcomes Measurement Information System (PROMIS) elements for patients who received L5-S1 interbody fusions for isthmic spondylolisthesis in the Mass General Brigham (MGB) health system (2016–2020). Intraclass correlation testing was used for reliability assessments; Mann-Whitney U tests and Sign tests were employed for intercohort and intracohort comparative analyses, respectively. Results. ALIFs generated greater segmental and L4-S1 lordosis than TLIF, both at first postoperative visit (mean 26 days [SE = 4]; 11.3° vs. 1.3°, P 
Source: Spine - Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research