الفهرس 
Anatomy of Lumbar VertebraOnly 14 pages are availabe for public view
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Abstract
Back pain is one of the most common diseases presenting to the orthopedic or physiotherapy clinic all over the world with prevalence up to 84%. Degenerative lumbar disc disorders are held responsible for low back pain.
Several surgical and non-surgical treatment options have been developed to reduce pain and improve function. Spinal fusion has become a commonly performed procedure for treating degenerative lumbar disorders. The optimal treatment for degenerative lumbar disease remains controversial.
Aim of study is to systematically review the literature regarding management of degenerative lumbar spine disorders by transforaminal lumbar interbody fusion (TLIF) with an emphasis on recent advances.
Anatomy of The intervertebral discs (IVD) consist of three major components: The inner, nucleus pulposus (NP), the outer, annulus (AF) and the cartilaginous endplates (CEP).
The human spine particularly the disc is subjected to an age-related disarrangement which proceeds with increasing age leading to “degeneration”. The extent of degenerated disc disease depends on age and affects various anatomic structures differently.
Diagnosis of degenerative disc disease By Clinical Evaluation ( History , Age ,Gender , BMI , Location of Pain & Aggravating and Alleviating Factors ) , Physical Examination ( red flag signs and waddel sign are important in diagnosis of DDD ) and Imaging of The Degenerated Disc ( Plain Radiographs , Computed Tomography and Magnetic Resonance Imaging (MRI) ).
Non-surgical treatment of DDD include treatment with Conservative Therapy to Relief Pain ( Physical Strengthening and Physiotherapy , Oral Medications and Pain-Relieving Injection) and treatment with Molecular Therapy Aims of Restoration, Repair, and Regeneration of Intervertebral Disc Diseases( Cell Therapy , Growth Factor Therapy and Gene Therapy ).
Surgical management for IVD diseases has been a constant source of debate among surgeons, pain specialists, and scientific communities. Surgical treatment caters to two groups of patients with different needs. The first group of patients with acute deterioration of neurology and/or cauda equina syndrome has a strong indication for early surgical management. The more common group consists of patients with chronic lower back pain, with imaging showing a degenerative disc with or without disc herniation.
Lumbar Interbody Fusion (LIF) is performed using five main approaches; posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF or MI-TLIF), oblique lumbar interbody fusion/anterior to psoas (OLIF/ATP), anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF) .
There are several advantages distinct to the TLIF approach and the unilateral (one-sided) aspect of the surgical technique. It maximizes fusion and spinal stability; the posterior elements are better preserved thereby reducing spinal destabilization. It allows for less nerve retraction during surgery, reduces scarring, and preserves more bony surface for fusion. It reduces the need to manipulate spinal nerve roots. The Operative time and blood loss are reduced. It affords the surgeon a larger working zone within the disc space. The working zone protects the spinal nerves, allows the surgeon to visualize nerve structures, and gain complete access to the disc space. A unique feature of the TLIF technique is its ability to restore interbody height and proper spinal curvature, which further helps to stabilize the spine and adds to its fusion potential.
Study Design: Systematic review.
Purpose: To assess the clinical and radiographic outcomes and complications OF transforaminal lumbar interbody fusion (TLIF).
Materials and Methods: A systematic search of multiple medical reference databases was conducted for transforaminal lumbar interbody fusion. Eligible studies included studies in which patient underwent TLIF.
Results: The search yielded 12 studies totaling 494patients. Study Fusion rate is 89.26 %. ODI improvement of study is 26.75. VAS improvement of study is 4.3. The rate of Neurological complications of the study is 5.9%. Infection rate of the study is 4.97 %. Dural injury rate of the study is 2.54. Blood vessel injury rate of the study is 0.0%. The rate of adjacent segment degeneration of the study is 7.5%.
Conclusions: study results demonstrate that TLIF effectively reduce the clinical VAS and ODI scores and restore the radiologic findings
Keywords: [TLIF; transforaminal lumbar interbody fusion; (ODI), Oswestry Disability; VAS, Visual Analogue Scale].