scholarly journals Comparison of Clinical Outcomes Following Lumbar Endoscopic Unilateral Laminotomy Bilateral Decompression and Minimally Invasive Transforaminal Lumbar Interbody Fusion for One-Level Lumbar Spinal Stenosis With Degenerative Spondylolisthesis

2021 ◽  
Vol 7 ◽  
Author(s):  
Wenbin Hua ◽  
Bingjin Wang ◽  
Wencan Ke ◽  
Qian Xiang ◽  
Xinghuo Wu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Clinical Outcomes ◽  
Spinal Stenosis ◽  
Complication Rate ◽  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Lumbar Spinal

Introduction: Both lumbar endoscopic unilateral laminotomy bilateral decompression (LE-ULBD) and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) have been used to treat one-level lumbar spinal stenosis (LSS) with degenerative spondylolisthesis, while the differences of the clinical outcomes are still uncertain.Methods: Among 60 consecutive patients included, 24 surgeries were performed by LE-ULBD and 36 surgeries were performed by MI-TLIF. Patient demographics, operation characteristics and complications were recorded. Sagittal parameters, including slip percentage (SP) and slip angle (SA) were compared. The visual analog scale (VAS) score, the Oswestry Disability Index (ODI) score, and Macnab criteria were used to evaluate the clinical outcomes. Follow-up examinations were conducted at 3, 6, 12, and 24 months postoperatively.Results: The estimated blood loss, time to ambulation and length of hospitalization of the LE-ULBD group were shorter than the MI-TLIF group. Preoperative and final follow-up SP of the LE-ULBD group was of no significant difference, while final follow-up SP of the MI-TLIF group was significantly improved compared with preoperative SP. The postoperative mean VAS and ODI scores decreased significantly in both LE-ULBD group and MI-TLIF group. According to the modified Macnab criteria, the outcomes rated as excellent/good rate were 95.8 and 97.2%, respectively, in both LE-ULBD group and MI-TLIF group. Intraoperative complication rate of the LE-ULBD and the MI-TLIF group were 4.2 and 0%, respectively. One case of intraoperative epineurium injury was observed in the LE-ULBD group. Postoperative complication rate of the LE-ULBD and the MI-TLIF group were 0 and 5.6%, respectively. One case with transient urinary retention and one case with pleural effusion were observed in the MI-TLIF group.Conclusion: Both LE-ULBD and MI-TLIF are safe and effective to treat one-level LSS with degenerative spondylolisthesis.

scholarly journals Minimally Invasive Transforaminal Lumbar Interbody Fusion at L5-S1 through a Unilateral Approach: Technical Feasibility and Outcomes

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Won-Suh Choi ◽  
Jin-Sung Kim ◽  
Kyeong-Sik Ryu ◽  
Jung-Woo Hur ◽  
Ji-Hoon Seong
Keyword(s):  
Minimally Invasive ◽  
Spinal Stenosis ◽  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Low Grade ◽  
Lumbar Interbody Fusion ◽  
Cage Subsidence

Background. Minimally invasive spinal transforaminal lumbar interbody fusion (MIS-TLIF) at L5-S1 is technically more demanding than it is at other levels because of the anatomical and biomechanical traits.Objective. To determine the clinical and radiological outcomes of MIS-TLIF for treatment of single-level spinal stenosis low-grade isthmic or degenerative spondylolisthesis at L5-S1.Methods. Radiological data and electronic medical records of patients who underwent MIS-TLIF between May 2012 and December 2014 were reviewed. Fusion rate, cage position, disc height (DH), disc angle (DA), disc slope angle, segmental lordotic angle (SLA), lumbar lordotic angle (LLA), and pelvic parameters were assessed. For functional assessment, the visual analogue scale (VAS), Oswestry disability index (ODI), and patient satisfaction rate (PSR) were utilized.Results. A total of 21 levels in 21 patients were studied. DH, DA, SLA, and LLA had increased from their preoperative measures at the final follow-up. Fusion rate was 86.7% (18/21) at 12 months’ follow-up. The most common cage position was anteromedial (15/21). The mean VAS scores for back and leg pain mean ODI scores improved significantly at the final follow-up. PSR was 88%. Cage subsidence was observed in 33.3% (7/21).Conclusions. The clinical and radiologic outcomes after MIS-TLIF at L5-S1 in patients with spinal stenosis or spondylolisthesis are generally favorable.

scholarly journals S-line as Predictor of Clinical Outcome for Patients Undergone Transforaminal Lumbar Interbody Fusion for Lumbar Spinal Stenosis

2021 ◽  
Author(s):  
Yilin Lu ◽  
Jian Zhu ◽  
Xi Luo ◽  
Kaiqiang Sun ◽  
Jingchuan Sun ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Interbody Fusion ◽  
Sagittal Alignment ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Significant Difference ◽  
Lumbar Spinal

Abstract Background: Some have speculated that LSTV has an impact on lumbar curve. A retrospective study was conducted to evaluate S-line as predictor of clinical outcome for patients undergone transforaminal lumbar interbody fusion for lumbar spinal stenosis.Methods: 126 patients undergoing transforaminal lumbar interbody fusion were enrolled. S-line stands for the connecting line between the highest points of the iliac crests on both sides. The patients were divided into two groups according to the position of S-line, S-line (-) group included patients whose S-line were between L4 and L5, and S-line (+) group included patients whose S-line is above or below this range, which were divided into two subgroups. Their pre-operative imaging data about sagittal alignment were collected, including lumbar lordosis (LL), sacral slope (SS), pelvic incidence (PI) and pelvic tilt (PT). Clinical outcomes were measured using Japanese Orthopaedic Association (JOA) scores, the Oswestry disability index (ODI), visual analog scale (VAS) before the surgery and postoperatively. The correlation of S-line and clinical outcomes, as well as sagittal alignment and clinical outcomes, were analyzed.Results: LL, SS, PI, PT and PI minus(-) LL of S-line (-) group were (45.39°±12.68°), (30.27°±10.55°), (43.32°±12.22°), (13.05°±6.52°), (-2.07°±8.20°), respectively, and those parameters of S-line (+) group were (40.29±14.92), (35.70°±14.09°), (52.59°±17.07°), (16.89°±8.24°), (12.30°±9.98°), respectively. Significant difference were seen in the above parameters between S-line (-) and S-line (+) group. For S-line (-) and S-line (+) group, post-operative JOA score were (22.39±2.12), (20.26±2.46), post-operative VAS were (2.07±0.88), (3.14±1.47), the post-operative ODI were (8.36±3.28), (11.82±3.32), the improvement rate is (0.61±0.13), (0.55±0.15), Significant differences of those parameters are seen between S-line (-) group and S-line (+) group.Conclusion: S-line is a reliable predictor of clinical outcome for patients undergone transforaminal lumbar interbody fusion for lumbar spinal stenosis.

Minimally invasive unilateral approach for bilateral decompression of spinal stenosis and modified transforaminal lumbar interbody fusion for degenerative spondylolisthesis

2013 ◽  
Vol 35 (v2supplement) ◽  
pp. Video4 ◽  
Author(s):  
Kevin S. Chen ◽  
Khoi D. Than ◽  
Frank LaMarca ◽  
Paul Park
Keyword(s):  
Minimally Invasive ◽  
Pedicle Screw ◽  
Spinal Stenosis ◽  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Invasive Approach ◽  
Unilateral Approach ◽  
Percutaneous Pedicle Screw

This video describes a minimally invasive approach for treatment of symptomatic grade I spondylolisthesis and high-grade spinal stenosis. In this procedure, a unilateral approach for bilateral decompression is utilized in conjunction with a modified transforaminal lumbar interbody fusion and percutaneous pedicle screw fixation. The key steps in the procedure are outlined, and include positioning, fluoroscopic positioning/guidance, exposure with tubular retractor system, technique for ipsilateral and contra-lateral decompression, disc space preparation and interbody grafting, percutaneous pedicle screw and rod placement, and closure.The video can be found here: http://youtu.be/QTymO4Cu4B0.

scholarly journals Minimally invasive transforaminal lumbar interbody fusion with reduction of spondylolisthesis: technique and outcomes after a minimum of 2 years' follow-up

2008 ◽  
Vol 25 (2) ◽  
pp. E16 ◽  
Author(s):  
Paul Park ◽  
Kevin T. Foley
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Oswestry Disability Index Score ◽  
Forward Translation ◽  
Scale Scores ◽  
The Mean

Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) is a relatively new surgical procedure that appears to minimize iatrogenic soft tissue and muscle injury. The authors describe a technique for MI-TLIF that permits the surgeon to reduce spondylolisthesis percutaneously. The results in 40 consecutive patients who underwent MI-TLIF for symptomatic spondylolisthesis utilizing this approach are reviewed. Thirty cases involved a degenerative spondylolisthesis while the remaining 10 were isthmic. The minimum follow-up was 24 months with a mean of 35 months. The mean preoperative Oswestry Disability Index score was 55, decreasing to a mean of 16 postoperatively. The mean leg and back pain visual analog scale scores were 65 and 52, respectively, improving to means of 8 and 15. Reduction of the spondylolisthesis was achieved in all cases, with a mean decrease in forward translation of 76%. The authors conclude that MI-TLIF for symptomatic spondylolisthesis appears to be an effective surgical option with results that compare favorably to open procedures.

scholarly journals Comparison of lumbar endoscopic unilateral laminotomy bilateral decompression and minimally invasive surgery transforaminal lumbar interbody fusion for one-level lumbar spinal stenosis

2020 ◽  
Author(s):  
Wenbin Hua ◽  
Bingjin Wang ◽  
Wencan Ke ◽  
Xinghuo Wu ◽  
Yukun Zhang ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Cauda Equina ◽  
Operation Time ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Estimated Blood Loss ◽  
Lumbar Spinal ◽  
Length Of Hospitalization

Abstract Background: The aim of the present study is to compare the clinical outcomes and postoperative complications of lumbar endoscopic unilateral laminotomy bilateral decompression (LE-ULBD) and minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF) to treat one-level lumbar spinal stenosis (LSS) without degenerative spondylolisthesis or deformity. Methods: A retrospective analysis of 112 consecutive patients of one-level LSS undergoing either LE-ULBD or MIS-TLIF was performed. Patient demographics, operation time, estimated blood loss, time to ambulation, length of hospitalization, intraoperative and postoperative complications were recorded. The visual analog scale (VAS) score for leg and back pain, the Oswestry Disability Index (ODI) score, and the Macnab criteria were used to evaluate the clinical outcomes. The healthcare cost was also recorded.Results: The operation time, estimated blood loss, time to ambulation and length of hospitalization of LE-ULBD group were shorter than MIS-TLIF group. The postoperative mean VAS and ODI scores decreased significantly in both groups. According to the modified Macnab criteria, the outcomes rated as excellent/good rate were 90.6% and 93.8% in the two groups. The mean VAS scores, ODI scores and outcomes of the modified Macnab criteria of both groups were of no significant difference. The healthcare cost of LE-ULBD group was lower than MIS-TLIF group. Two cases of intraoperative epineurium injury were observed in the LE-ULBD group. One case of cauda equina injury was observed in the LE-ULBD group. No nerve injury, dural injury or cauda equina syndrome was observed in MIS-TLIF group. However, one case with transient urinary retention, one case with pleural effusion, one case with incision infection and one case with implant dislodgement were observed in MIS-TLIF group. Conclusions: Both LE-ULBD and MIS-TLIF are safe and effective to treat one-level LSS without degenerative spondylolisthesis or deformity. LE-ULBD is a more minimally invasive option and of less economic burden compared with MIS-TLIF. Decompression plus instrumented fusion may be not necessary for one-level LSS without degenerative spondylolisthesis or deformity.

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