CT-Mapped Fusion Patterns After 360° Transforaminal Lumbar Interbody Fusion (TLIF) for Degenerative Spondylolisthesis - High Facet and Interbody Fusion Rates With Limited Clinical Correlates

Q: What was the main objective of this study on TLIF?

To compare CT-confirmed fusion across predefined anatomical zones after 360° TLIF and to evaluate baseline-to-12-month changes in ODI and RMDQ.

Q: How many patients were analyzed and what imaging was used?

Eighty-eight retrospective patients underwent 360° TLIF, and fusion was assessed on a 12-month follow-up CT.

Q: Did fusion location or the number of fused zones affect clinical disability?

No. Fusion location/number did not correlate with postoperative ODI or RMDQ at 12 months.

Sep 29, 2026

Uploaded by jayni

Degenerative spondylolisthesis is a frequent cause of low back pain and disability. This study evaluated CT-confirmed fusion rates across predefined lumbar anatomical zones after 360° transforaminal lumbar interbody fusion (TLIF), and assessed baseline-to-12-month changes in ODI and RMDQ. Ninety-day? no—88 retrospective patients underwent CT at 12 months; fusion success was high, complications were uncommon, and fusion location/number showed no correlation with disability.

LanguageEnglish

CategoryHealthcare

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Pages13

Reading Time33 min

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Abstract

Introduction

Methods

Results

Discussion

How to cite this article

Review began 10/28/2025 Review ended 11/26/2025 Published 12/05/2025 © Copyright 2025 García-Ramos et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.98535 Open Access Original Article CT-Mapped Fusion Patterns After 360° Transforaminal Lumbar Interbody Fusion (TLIF) for Degenerative Spondylolisthesis: High Facet and Interbody Fusion Rates With Limited Clinical Correlates Carla García-Ramos 1, Diego-Alberto Nuñez-Arreola 1 , Diana-Laura Hernandez Moctezuma 1, Alejandro Antonio Reyes-Sanchez 1, Armando Alpizar-Aguirre 1 , Baron Zarate-Kalfopulos 1, Irving O. Estevez-Garcia 1, Ernesto Roldan-Valadez 2, 3 1. Spinal Surgery, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra ", Mexico City, MEX 2. Research, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra ", Mexico City, MEX 3. Radiology, I.M. Sechenov First Moscow State Medical University, Moscow, RUS Corresponding author: Ernesto Roldan-Valadez, [ernest.roldan@usa.net](ernest.roldan@usa.net) Abstract Introduction: Degenerative spondylolisthesis is a common cause of low back pain and disability. We evaluated fusion rates across predefined lumbar regions and their association with clinical outcomes after transforaminal lumbar interbody fusion (TLIF) . We aimed to compare CT-confirmed fusion across predefined anatomical zones and to assess baseline-to-12-month changes in Oswestry Disability Index (ODI) and Roland-Morris Disability Questionnaire (RMDQ) . Methods: We retrospectively analyzed 88 patients who underwent 360° TLIF at the Mexican National Rehabilitation Institute (January 2017-May 2022) . Fusion at seven anatomical zones was assessed on a 12-month follow-up CT. Patient-reported outcomes at 12 months included the ODI and the RMDQ. Results: Operations most commonly involved L4-L5 (38; 43. 1%), followed by L4-L5+L5-S1 (31; 35.3%), L3-L4+L4-L5 (12; 13. 7%), L5-S1 (5; 5.9%), and L2-L3+L3-L4+L4-L5 (2; 2.0%) . Fusion success was high, particularly for interbody fusion (79; 89.6%, p < 0 .0001) and facet joint fusion. Complications were uncommon (8; 9. 1%): pedicle fracture (2; 2.3%), durotomy (1; 1. 1%), dural injury (1; 1. 1%), transient nerve alteration on neuromonitoring (2; 2.3%), L4 spinous-process fracture (1; 1. 1%), and screwdriver breakage with retained fragment (1; 1. 1%) . Fusion location/number did not correlate with postoperative ODI (p = 0. 7124) or RMDQ (p = 0 .4255) . Several fusion types were more often successful in female patients (p < 0 .01) . Discussion: TLIF achieved high CT-confirmed fusion-especially interbody and facet-yet the anatomical distribution/number of fused zones did not influence 12-month disability (ODI/RMDQ) . Results likely reflect surgical technique and patient optimization rather than fusion location. Interpretation should be cautious given the retrospective single-center design, 12-month follow-up, lack of bone-quality data, and exploratory multiple comparisons. Categories: Radiology, Physical Medicine & Rehabilitation, Orthopedics Keywords: clinical outcomes, degenerative spondylolisthesis, fusion success rates, lumbar spine fusion surgery, oswestry disability index (odi), postoperative complications, quality of life, roland-morris questionnaire, transforaminal lumbar interbody fusion (tlif) Introduction The term spondylolisthesis, first introduced by Killian in 1853, denotes anterior displacement of one vertebra relative to the one below; posterior displacement of the superior vertebra is termed retrolisthesis [1] . Instability arises within the paravertebral joint complex: vertebral body, intervertebral disc, and facet joints [2] . Degenerative spondylolisthesis is the most frequent form in individuals over 50 years of age and is a leading caus

FAQs

What was the main objective of this study on TLIF?

To compare CT-confirmed fusion across predefined anatomical zones after 360° TLIF and to evaluate baseline-to-12-month changes in ODI and RMDQ.

How many patients were analyzed and what imaging was used?

Eighty-eight retrospective patients underwent 360° TLIF, and fusion was assessed on a 12-month follow-up CT.

Did fusion location or the number of fused zones affect clinical disability?

No. Fusion location/number did not correlate with postoperative ODI or RMDQ at 12 months.

Sep 29, 2026

Uploaded by jayni