Abstract
Introduction
The technique of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has been successfully used to treat lumbar degenerative diseases with the advantages of less intraoperative blood loss, perioperative narcotic requirements, quick postoperative recovery, and shorter hospital length of stay. However, to our knowledge, there are few reports about the application of MIS-TLIF in the treatment of isthmic spnodylolisthesis. The purpose of the present study is to investigate the clinical and radiological outcome of the MIS-TLIF in the treatment of grades I to II isthmic spondylolisthesis.
Materials and Methods
From January 2011 to September 2012, 17 consecutive cases of grades I to II isthmic spondylolisthesis were treated with MIS-TLIF. Radiographs were obtained before and after surgery, 3 months postoperatively, and at the final follow-up to determine the percentage of the slippage, segmental lordosis (SL) and lumbar lordosis (LL), presence of fusion, and hardware-related problems. The clinical outcomes were evaluated using the Oswestry disability index before and after surgery, and at the final follow-up. The visual analog scale score of back pain and radicular pain were evaluated as well. The intraoperative data and perioperative complications were recorded.
Results
Mean follow-up period was 13 months (range, 6-25 months). Mean operating time was 153 minutes, mean intraoperative blood loss was 175 mL, mean postoperative hospitalization was 3.7 days. Eleven cases got complete reduction, five cases got partial reduction, and one case no reduction. The mean SL was 2.4 degrees preoperatively and 14.9 degrees postoperatively; the mean LL was 50.1 degrees preoperatively and 51.9 degrees postoperatively, both SL and LL were significantly improved after surgery (p < 0.05). There were 15 cases got fusion at the final follow-up (88.2%). The mean ODI was 49.6% before surgery and significantly improved to 22.7% at the final follow-up. There was one patient got transient radicular pain after surgery and was recover after conservative treatment. There is no hardware failure.
Conclusion
MIS-TLIF is safe and effective for the treatment of grades I to II isthmic spondylolisthesis. For carefully selected patient, direct decompression of exiting nerve is not necessary.
None declared