Transforaminal lumbar interbody fusion in spondylolisthesis: a prospective evaluation of clinical, radiological, and functional outcomes in a Central Indian cohort

Abstract

Background: Spondylolisthesis, or anterior vertebral displacement, is a complex spinal disorder characterized by diverse symptoms and various treatment approaches. Transforaminal Lumbar Interbody Fusion (TLIF) is increasingly preferred over Posterior Lumbar Interbody Fusion (PLIF); however regional data in India are limited.

Objective: This prospective study evaluated clinical, radiological, and functional outcomes after TLIF in lumbar spondylolisthesis patients treated at a tertiary center in central India.

Methods: Fifty adult patients with Grade II–IV lumbar spondylolisthesis underwent TLIF. Assessments included pain (Visual Analogue Scale, VAS), disability (Oswestry Disability Index, ODI), neurological status, slip angle correction, fusion rates, and complications pre- and postoperatively. Statistical significance was set at p < 0.05.

Results: Locations L4–L5 (56%) and L5–S1 (44%) were the affected levels. The mean preoperative VAS and ODI scores were 7.4±1.0 and 74±10%. At 6 months follow-up, VAS decreased by 71.6% to 2.1, and ODI by 88% to 9.5% (p < 0.001). Neurological recovery included full motor deficit resolution and 92% sensory improvement. The mean slip angle correction was 14.6±5.3°, and the fusion success rate was 92%. Complications were minimal, including 4% wound infection and 4% transient neurological deficits, with no implant failures.

Conclusion: TLIF shows excellent short-term results, offering substantial pain relief, functional and neurological recovery, and high fusion rates in Indian patients with moderate-to-severe spondylolisthesis. Further studies with larger sample sizes and longer follow-up periods are warranted to validate these findings.