An article published in Spine examines the optimum fusion technique for patients with adult spondylolisthesis.
The researchers compared study results for posterolateral fusion, posterior lumbar interbody fusion and PLIF plus PLF. They conducted a systematic review of MEDLINE, EMBASE and the Cochrane Collection Library from 1950 to 2013. There were four randomized controlled trials and 13 observational studies included in the analysis.
The researchers found:
1. PLIF was more effective in reaching clinical satisfaction than PLF.
2. There was no significant difference in the primary outcomes for PLF and PLIF plus PLF.
3. No significant difference in complication rate between PLIF, PLF and PLIF plus PLF.
4. PLIF achieved better fusion rate improvement than PLF. PLIF also had a better reoperation rate.
5. PLIF plus PLF was not superior to PLF.
"PLIF may be better than the other two fusion methods for treating lumbar spondylolisthesis," the study authors concluded. "However, conclusions need to be treated with caution because of lack of high quality evidence."