Enhanced Early Stabilization and Improved Clinical Outcomes by Transforaminal Lumbar Interbody Fusion With Contralateral Facet Fusion Compared With Conventional Posterior Lumbar Interbody Fusion

Background: This study introduces and evaluates the transforaminal lumbar interbody fusion technique with contralateral facet fusion (TLIFcFF), aiming to improve fusion rates and clinical outcomes compared to conventional posterior lumbar interbody fusion (PLIF). Methods: A retrospective case-control study was conducted on patients undergoing TLIFcFF or PLIF between July 2009 and November 2020. Patients with one-or two-level lumbar fusion were included, excluding cases involving long-level fusions, revision surgeries, or other diseases. Perioperative parameters, radiological outcomes, fusion rates, and clinical outcomes were analyzed. Results: The study included 101 patients in the TLIFcFF group and 89 in the PLIF group, with a mean follow-up of 57 months. TLIFcFF demonstrated higher fusion rates at six months (84.9% vs. 66.4%, P < 0.001) but comparable fusion rates at one year. TLIFcFF showed significant improvements in low back pain and radiating pain scores at 3, 6, and 12 months postoperatively (P < 0.05). There were no significant differences in complications, operation time, or functional outcomes (Oswestry Disability Index, Functional Rating Index) between groups. Conclusion: TLIF with contralateral facet fusion represents a viable alternative to conventional PLIF, demonstrating advantages in early fusion rates and reduced pain within the first year. Further prospective studies are warranted to validate these findings.