Comparison of the efficacy of posterior lumbar interbody fusion and transforaminal lumbar interbody fusion in the treatment of double-level lumbar spondylolisthesis combined with spinal stenosis: a retrospective comparative study.

OBJECTIVE

To compare the clinical and radiographic outcomes of posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of double-level lumbar spondylolisthesis combined with spinal stenosis.

METHODS

This retrospective comparative study included 44 patients with double-level lumbar spondylolisthesis combined with spinal stenosis who underwent surgical treatment between April 2013 and August 2021. Patients were divided into PLIF and TLIF groups. Perioperative parameters, complications, and clinical outcomes, including visual analog scale (VAS) scores for back and leg pain and the Oswestry Disability Index (ODI), were evaluated preoperatively and at 1 week, 6 months, 12 months, and 24 months postoperatively. Radiographic parameters related to sagittal alignment and vertebral slippage were also assessed. Statistical analyses were performed using appropriate parametric or non-parametric tests based on data distribution.

RESULTS

Baseline characteristics were comparable between the two groups (P > 0.05). No major intraoperative complications or implant-related failures were observed. Both groups demonstrated significant improvements in VAS scores and ODI at all postoperative time points compared with preoperative values (P < 0.05), with no significant differences between groups (P > 0.05). Radiographic parameters showed significant postoperative improvement in both groups (P < 0.05). Although the TLIF group demonstrated numerically greater improvements in certain sagittal alignment parameters, these differences did not reach statistical significance.

CONCLUSION

Both PLIF and TLIF are effective surgical options for the treatment of double-level lumbar spondylolisthesis combined with spinal stenosis, resulting in significant clinical and radiographic improvement. No significant differences in clinical outcomes were observed between the two techniques. While TLIF may show a trend toward improved restoration of certain sagittal alignment parameters, these findings should be interpreted with caution.