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Year : 2021  |  Volume : 9  |  Issue : 2  |  Page : 56-59

Surgical treatment of symptomatic non-union after transforaminal lumbar interbody fusion

Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY, USA

Correspondence Address:
Dr. Leah Y Carreon
Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JOASP.JOASP_63_21

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INTRODUCTION: Transforaminal lumbar interbody fusion (TLIF) is frequently performed to treat lumbar degenerative diseases. As with any fusion procedure, there are patients who fail to achieve a solid fusion and require revision surgery. The purpose of this study is to evaluate the clinical and functional outcomes of revision procedures performed by different approaches for non-union following TLIF. MATERIALS AND METHODS: Electronic medical records and radiographs of 52 adult patients with symptomatic non-union confirmed at surgery after single or multilevel TLIF who underwent revision surgery from 2012 to 2019 and had at least 1-year follow-up were reviewed. Data collected included demographics, surgical approach, numeric back and leg pain scores (0–10), Oswestry Disability Index scores before and after revision and complications. RESULTS: Revision for non-union was performed for an average of 31.7 months, following the index procedure. Fifteen patients underwent an anterior-only approach, and 28 cases underwent a combined anteroposterior approach with exchange of posterior instrumentation and decompression. Nine cases underwent a posterior-only approach with or without decompression and bone graft on the lateral gutters. There were no significant differences between various surgical approaches in terms of demographics, surgical parameter, pain relief, functional improvement, or complications. CONCLUSIONS: The current study showed that improvement of clinical symptoms and functional outcome was less than 50%, regardless of the surgical approach type. A low percentage of individuals experienced aggravation of leg pain, back pain, or dysfunction. There was also no distinctive advantage for any individual approach in TLIF revision.

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