Outcomes of Anterior Lumbar Interbody Fusion versus Transforaminal Lumbar Interbody Fusion in Degenerative Spine Diseases at Lumbosacral Junction; Systematic Review

Abstract

Background: degenerative spine diseases are a leading cause of back pain and radiculopathy. Lumbar interbody fusion provides a good treatment modality after failure of other options. Over years several approaches have been developed to achieve interbody fusion. Methods: searches were conducted in three electronic databases including Ovid Medline, Pubmed and Cochrane. Results: twelve studies were obtained comparing outcomes of Anterior Lumbar Interbody Fusion and Transforaminal Lumbar Interbody Fusion. There was no significant difference in fusion rates and clinical outcomes between ALIF and TLIF. ALIF was superior in restoring the disc height and lumbar lordosis. Complications were comparable between both approaches except for dural injury which was higher in TLIF and blood vessel injury which was higher in ALIF. Conclusion: both approaches were similar in achieving fusion and clinical outcomes. Sagittal alignment was better restored in ALIF. Each approach has specific complications related to the exposure. Keywords: "anterior lumbar interbody fusion" or "ALIF", "transforaminal lumbar interbody fusion" or "TLIF" and "lumbar spondylosis".