Posterior Lumbar Interbody Fusion versus Intertransverse Fusion in the Treatment of Lumbar Spondylolisthesis

1. Inamdar DN, Alagappan M, Shyam L, Devadoss S, Devadoss A. Posterior lumbar interbody fusion versus intertransverse fusion in the treatment of lumbar spondylolisthesis. J Orthop Surg (Hong Kong) 2006;14:21–6. 2. Dehoux E, Fourati E, Madi K, Reddy B, Segal P. Posterolateral versus interbody fusion in isthmic spondylolisthesis: functional results in 52 cases with a minimum follow-up of 6 years. Acta Orthop Belg 2004;70:578–82. 3. Madan S, Boeree NR. Outcome of posterior lumbar interbody fusion versus posterolateral fusion for spondylolytic spondylolisthesis. Spine 2002;27:1536–42. 4. Sears W. Posterior lumbar interbody fusion for degenerative spondylolisthesis: restoration of sagittal balance using insertand-rotate interbody spacers. Spine J 2005;5:170–9. 5. Sears W. Posterior lumbar interbody fusion for lytic spondylolisthesis: restoration of sagittal balance using insert-and-rotate interbody spacers. Spine J 2005;5:161–9. To the Editor: I would like to comment on the article by Inamdar et al.1 The authors claimed that “this is the first prospective study to compare the 2 methods.” However, there have been manuscripts comparing these 2 methods in the literature.2,3 The authors concluded that “intertransverse fusion (ITF) has less morbidity and complication than posterior lumbar interbody fusion (PLIF). ITF is recommended because of the simplicity of the procedure, lower complication rate, and good clinical and radiological results.”1 However, they randomly divided the 2 groups regardless of slip degree and slip angle. Posterolateral fusion is a good and valuable option for low-grade spondylolysthesis but not for high grade.2,3 Dehoux et al.2 have advocated the use of poster ior interbody fusion for high-grade spondylolisthesis requiring reduction or when the disc space is still high.2 Correction of saggital balance and maintenance of disc height is very important for spondylolisthetic patients. Achievement of this fine tuning can easily be done with PLIF.4,5