Comparison of Minimally Invasive Transforaminal and Anterolateral Lumbar Interbody Fusion for Treatment of Low-grade Lumbar Spondylolisthesis

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Lei Zhu ◽  
Pingchuan Wang ◽  
Liang Zhang ◽  
Xinmin Feng ◽  
Wenjie Zhang
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Low Grade ◽  
Lumbar Interbody Fusion ◽  
Lumbar Spondylolisthesis

Minimally invasive surgery for low-grade spondylolisthesis: percutaneous endoscopic or oblique lumbar interbody fusion

2020 ◽  
Vol 9 (9) ◽  
pp. 639-650
Author(s):  
Mengran Jin ◽  
Guokang Xu ◽  
Tong Shen ◽  
Jun Zhang ◽  
Haiyu Shao ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Low Grade ◽  
Lumbar Interbody Fusion ◽  
Radiographic Outcomes ◽  
Oblique Lumbar Interbody Fusion ◽  
Lumbar Spondylolisthesis ◽  
Foraminal Height ◽  
Perioperative Risks

Aim: To compare the clinical and radiographic outcomes of percutaneous endoscopic-assisted lumbar interbody fusion (PELIF) versus oblique lumbar interbody fusion (OLIF) for the treatment of symptomatic low-grade lumbar spondylolisthesis. Material & methods: The clinical and radiographic records of 48 patients underwent single-level minimally invasive lumbar fusion with a PELIF (n = 16) or OLIF (n = 32) were reviewed. Results: The clinical and radiographic outcomes were similar in both groups. PELIF procedure exhibited superior capability of the enlargement of foraminal width, but inferior capability of the restoration of foraminal height than OLIF procedure. Conclusion: PELIF minimizes the iatrogenic damages and perioperative risks to a great extent, and seems to be a promising option for the treatment of symptomatic low-grade lumbar spondylolisthesis.

A Comparison of Minimally Invasive and Open Transforaminal Lumbar Interbody Fusion for Grade 1 Degenerative Lumbar Spondylolisthesis: An Analysis of the Prospective Quality Outcomes Database

Neurosurgery ◽  
2020 ◽  
Vol 87 (3) ◽  
pp. 555-562 ◽  
Author(s):  
Andrew K Chan ◽  
Erica F Bisson ◽  
Mohamad Bydon ◽  
Kevin T Foley ◽  
Steven D Glassman ◽  
...  
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Sample Size ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Small Sample ◽  
Lumbar Interbody Fusion ◽  
Quality Outcomes ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis

ABSTRACT BACKGROUND It remains unclear if minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) is comparable to traditional, open TLIF because of the limitations of the prior small-sample-size, single-center studies reporting comparative effectiveness. OBJECTIVE To compare MI-TLIF to traditional, open TLIF for grade 1 degenerative lumbar spondylolisthesis in the largest study to date by sample size. METHODS We utilized the prospective Quality Outcomes Database registry and queried patients with grade 1 degenerative lumbar spondylolisthesis who underwent single-segment surgery with MI- or open TLIF methods. Outcomes were compared 24 mo postoperatively. RESULTS A total of 297 patients were included: 72 (24.2%) MI-TLIF and 225 (75.8%) open TLIF. MI-TLIF surgeries had lower mean body mass indexes (29.5 ± 5.1 vs 31.3 ± 7.0, P = .0497) and more worker's compensation cases (11.1% vs 1.3%, P < .001) but were otherwise similar. MI-TLIF had less blood loss (108.8 ± 85.6 vs 299.6 ± 242.2 mL, P < .001), longer operations (228.2 ± 111.5 vs 189.6 ± 66.5 min, P < .001), and a higher return-to-work (RTW) rate (100% vs 80%, P = .02). Both cohorts improved significantly from baseline for 24-mo Oswestry Disability Index (ODI), Numeric Rating Scale back pain (NRS-BP), NRS leg pain (NRS-LP), and Euro-Qol-5 dimension (EQ-5D) (P > .001). In multivariable adjusted analyses, MI-TLIF was associated with lower ODI (β = −4.7; 95% CI = −9.3 to −0.04; P = .048), higher EQ-5D (β = 0.06; 95% CI = 0.01-0.11; P = .02), and higher satisfaction (odds ratio for North American Spine Society [NASS] 1/2 = 3.9; 95% CI = 1.4-14.3; P = .02). Though trends favoring MI-TLIF were evident for NRS-BP (P = .06), NRS-LP (P = .07), and reoperation rate (P = .13), these results did not reach statistical significance. CONCLUSION For single-level grade 1 degenerative lumbar spondylolisthesis, MI-TLIF was associated with less disability, higher quality of life, and higher patient satisfaction compared with traditional, open TLIF. MI-TLIF was associated with higher rates of RTW, less blood loss, but longer operative times. Though we utilized multivariable adjusted analyses, these findings may be susceptible to selection bias.

Transfacet Minimally Invasive Transforaminal Lumbar Interbody Fusion With an Expandable Interbody Device—Part I: 2-Dimensional Operative Video and Technical Report

2020 ◽  
Vol 19 (5) ◽  
pp. E473-E479
Author(s):  
Jawad M Khalifeh ◽  
Christopher F Dibble ◽  
Priscilla Stecher ◽  
Ian Dorward ◽  
Ammar H Hawasli ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Preoperative Imaging ◽  
Low Grade ◽  
Lumbar Interbody Fusion ◽  
Screw Insertion ◽  
Articular Process ◽  
Spinal Reconstruction ◽  
Indirect Decompression

Abstract BACKGROUND Advances in operative techniques and minimally invasive technologies have evolved to maximize patient outcomes and radiographic results, while reducing morbidity and recovery time. OBJECTIVE To describe the operative technique for a transfacet minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) as a proposed modification to the standard approach MIS-TLIF. METHODS We present the case of a 72-yr-old man with left-sided lumbar radiculopathy. Preoperative imaging demonstrated degenerative lumbar anterolisthesis at L4-5, with associated canal and neuroforaminal stenosis. The patient underwent transfacet MIS-TLIF at L4-L5. We describe the preoperative planning, patient positioning, incision and dissection, pedicle screw insertion, transfacet approach to the working access corridor, discectomy, interbody device placement, fixation, and closure. RESULTS The transfacet MIS-TLIF utilizes 3 key techniques to safely maximize surgical correction: (1) a limited bony resection based on the superior articular process, leaving the medial inferior articular process, lateral superior articular process, and rostral pars intact, providing a working bony corridor that protects the traversing and exiting nerve roots; (2) decortication and release of the contralateral facet joint to provide additional capacity for indirect decompression and provide the first point of osseous fusion; and (3) placement of an expandable interbody device that provides additional indirect decompression to the working side and contralateral foramen. CONCLUSION The transfacet MIS-TLIF uniquely leverages a bony working corridor to access the disc space for discectomy and interbody placement. Transfacet MIS-TLIF is a feasible solution for lumbar spinal reconstruction to maximize direct and indirect decompression of the neuroforamina and central spinal canal in patients with lumbar degenerative diseases and low-grade spondylolisthesis.

scholarly journals A Comparison of Minimally Invasive and Open Transforaminal Lumbar Interbody Fusion for Grade 1 Degenerative Lumbar Spondylolisthesis: An Analysis of the Prospective Quality Outcomes Database

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Andrew Kai-Hong Chan ◽  
Erica F Bisson ◽  
Mohamad Bydon ◽  
Steven D Glassman ◽  
Kevin T Foley ◽  
...  
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Interbody Fusion ◽  
Statistical Significance ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Home Healthcare ◽  
Lumbar Interbody Fusion ◽  
Quality Outcomes ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis

Abstract INTRODUCTION Here, we compare minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) to traditional, open TLIF for grade 1 degenerative lumbar spondylolisthesis in the largest study to date by sample size. METHODS We utilized the multicenter, prospective Quality Outcomes Database registry and queried patients with grade 1 degenerative lumbar spondylolisthesis who underwent single-segment surgery with fully minimally invasive or open TLIF methods. Outcomes were compared 24 mo postoperatively: Oswestry Disability Index (ODI), Numeric Rating Scale Back Pain (NRS-BP), NRS Leg Pain (NRS-LP), EuroQol-5D (EQ-5D), North American Spine Society (NASS) Satisfaction Score, cumulative reoperation rate, and return to work (RTW) rate. Multivariate analyses were utilized to adjust for variables reaching P < .20 on univariate analyses. RESULTS A total of 297 patients were included: 72 (24.2%) MI-TLIF and 225 (75.8%) open TLIF. Average age (MI-TLIF: 62.1 vs open TLIF: 59.5 yr) was similar (P = .10). MI-TLIF surgeries were associated with lower body mass index (29.5 ± 5.1 vs 31.3 ± 7.0, P = .0497) and more workman's compensation cases (11.1% vs 1.3%, P = .001). Patients did not differ significantly at baseline for ODI, NRS BP, NRS LP and EQ-5D (P > .05). MI-TLIF was associated with less blood loss (108.8 ± 85.6 vs 299.6 ± 242.2 mL, P < .001), longer operations (228.2 ± 111.5 vs 189.6 ± 66.5 min, P < .001), and a trend toward decreased length of hospitalization (2.9 ± 1.8 vs 3.3 ± 1.6 d, P = 0.08). Discharge disposition to home or home healthcare was similar (94.4% vs 91.1%, P = .38). Both cohorts improved significantly from baseline for 24-month ODI, NRS-BP, NRS-LP, and EQ-5D (P > .001). In adjusted analyses, MI-TLIF was associated with superior ODI (ß = −4.7; 95% CI-9.3 −0.04; P = .048) and EQ-5D (ß = 0.06; 95% CI 0.009-0.11; P = .02). Though trends for superiority were evident for MI-TLIF, they did not reach statistical significance for NRS-BP (P = .06), NRS-LP (P = .07), and NASS Satisfaction (P = .06). Similarly, there was a trend for fewer reoperations following MI-TLIF, though this did not reach statistical significance (1.4% vs 7.6%, P = .10). A higher proportion of MI-TLIF patients were able to RTW following surgery (100% vs 80%, P = .02). CONCLUSION For single-level grade 1 degenerative lumbar spondylolisthesis, MI-TLIF was associated with superior outcomes for disability and quality of life compared with traditional, open TLIF. MI-TLIF was associated with higher rates of RTW and less blood loss, but longer operative times.

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