Brain & spine · 2026
Transforaminal lumbar interbody fusion (TLIF) with or without anterior release (TFAR) using expandable interbody spacers - comparative cohort study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Stienen Martin N, Feuerstein Laurin, Stengel Felix C, Bertulli Lorenzo, Bättig Linda, Yildiz Yesim, Fischer Gregor, Kissling Francis, Schöfl Thomas, Hejrati Nader, Gianoli Daniele, Motov Stefan, Martens Benjamin
Аннотация
INTRODUCTION: Transforaminal lumbar interbody fusion (TLIF) can be extended by transforaminal anterior release (TFAR), to open and distract degenerated segments and increase segmental lordosis (SL).
RESEARCH QUESTION: To analyze the rate, type and severity of adverse events (AEs), as well as spinopelvic parameters and clinical outcomes.
MATERIAL AND METHODS: We reviewed consecutive patients treated with TLIF with expandable interbody spacers. TFAR patients were matched 1:5 to a control group (conventional TLIF).
RESULTS: We identified n = 435 patients (541 TLIF levels; mean age 65.2 years; 55.7% female), of which n = 30 patients (39 levels) were assigned to the TFAR group and n = 149 (247 TLIF levels) to the control group. TFAR procedures took longer (mean difference (MD) 86min, p = 0.004) and had a higher blood loss (MD 463 ml, p = 0.022). In multivariable analysis, TFAR patients were more likely to experience intraoperative AEs (OR 3.49, 95% CI 1.47 - 8.31, p = 0.005) and early postoperative AEs (OR 2.39, 95% CI 0.99 - 5.76, p = 0.051), while the risk for further AEs at 90 days and 12 months was similar. Patients in the TFAR group were more likely to achieve a favorable 12-month outcome (OR 2.71, 95% CI 1.13 - 6.51, p = 0.025). TFAR patients had consistently more SL during follow-up (12 month: 24.9° vs. 18.9°, p < 0.001) and the pelvic incidence (PI)-LL mismatch was lower (0.4° vs. 7.2°, p = 0.020).
DISCUSSION AND CONCLUSION: We found a 3-fold increase in intraoperative and early postoperative AEs in TFAR patients, while the mid- and longer-term outcomes were similar or even slightly better than in patients undergoing conventional TLIF.
RESEARCH QUESTION: To analyze the rate, type and severity of adverse events (AEs), as well as spinopelvic parameters and clinical outcomes.
MATERIAL AND METHODS: We reviewed consecutive patients treated with TLIF with expandable interbody spacers. TFAR patients were matched 1:5 to a control group (conventional TLIF).
RESULTS: We identified n = 435 patients (541 TLIF levels; mean age 65.2 years; 55.7% female), of which n = 30 patients (39 levels) were assigned to the TFAR group and n = 149 (247 TLIF levels) to the control group. TFAR procedures took longer (mean difference (MD) 86min, p = 0.004) and had a higher blood loss (MD 463 ml, p = 0.022). In multivariable analysis, TFAR patients were more likely to experience intraoperative AEs (OR 3.49, 95% CI 1.47 - 8.31, p = 0.005) and early postoperative AEs (OR 2.39, 95% CI 0.99 - 5.76, p = 0.051), while the risk for further AEs at 90 days and 12 months was similar. Patients in the TFAR group were more likely to achieve a favorable 12-month outcome (OR 2.71, 95% CI 1.13 - 6.51, p = 0.025). TFAR patients had consistently more SL during follow-up (12 month: 24.9° vs. 18.9°, p < 0.001) and the pelvic incidence (PI)-LL mismatch was lower (0.4° vs. 7.2°, p = 0.020).
DISCUSSION AND CONCLUSION: We found a 3-fold increase in intraoperative and early postoperative AEs in TFAR patients, while the mid- and longer-term outcomes were similar or even slightly better than in patients undergoing conventional TLIF.