Circumferential minimally invasive approach for low-grade isthmic spondylolisthesis: A clinical and radiological study of 43 patients

Farah, Kaissar; Graillon, Thomas; Rakotozanany, P.; Pesenti, Sébastien; Blondel, Benjamin; Fuentès, S.

doi:10.1016/j.otsr.2018.02.004

Cited by 10 publications

(7 citation statements)

References 18 publications

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“…Regarding clinical outcome, the scores collected were satisfactory with a mean VAS-L and VAS-R at last follow-up respectively at 2.3 and 1. These results are comparable with the series of Farah et al which included 43 patients treated with minimallyinvasive surgery, that found respectively 2 and 1 for VAS-L and VAS-R (13). Mean ODI at followup in this study was 13.8% whereas Koné et al, in a similar cohort of 27 patients, found a mean ODI at 28.7% (14).…”

Section: Discussionsupporting

confidence: 88%

“…Tye et al exhibited better clinical and radiological outcomes for double approaches comparing to TLIF (12). Farah et al showed good outcomes with ALIF and percutaneous pedicle fixation (13).…”

Section: Discussionmentioning

confidence: 99%

“…The iliac crest, rh-BMP2 has been used in only 6% of the patients. The most used cages were of 14-or 12-millimeters height [8][9][10][11][12][13][14][15][16], respectively 40 and 36%, and of 14-and 10-degrees lordosis [6][7][8][9][10][11][12][13][14][15][16], respectively 47 and 35%. One arthrodesis of the two last mobile levels has been performed in 6 patients (7%).…”

Section: Radiological Datamentioning

confidence: 99%

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Isthmic spondylolisthesis treated with circumferential arthrodesis (ALIF and posterior fixation): correction, fusion and indirect decompression

Khalifé¹,

Dauzac²,

Lenoir³

et al. 2021

Acta Orthop Belg

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There is no consensus regarding the choice of the surgical technique for isthmic spondylolisthesis treatment, although they all aim to a common goal, achieving fusion at the index level while restoring an appropriate lordosis and remove potential radicular compression. Analyze outcome of circumferential arthrodesis (CA) with ALIF (Anterior Lumbar Interbody Fusion) and pedicle screw fixation for the treatment of all-grade isthmic spondylolisthesis, with indirect neurological decompression. Retrospective study of isthmic spondylolisthesis treated with CA, with one-year follow-up. Clinical scores were collected at one year: VAS-L, VAS-R and ODI. Pelvic parameters, L4-S1 lordosis and at index and adjacent levels, and lumbo-sacral angle (LSA) were measured pre- and post-operatively and at last follow-up. Foraminal surface and diameters were measured pre- operatively and at follow-up on CT-Scan. Level of evidence: IV. 87 patients were included. Mean VAS-L was 2.3, mean VAS-R was 1, and mean ODI was 13.8%. 10% of the patients presented a high-grade spondylolisthesis and 50% a grade II. Mean lordosis at index level shifted from 6° to 18°, L4-S1 lordosis increased from 37 to 45° and LSA shifted from 116 to 125° (p<0.001). The foraminal surface increased from 50mm 2 to 70mm 2 at last follow-up mostly through the supero-inferior diameter, shifting from 7.4mm to 9.5mm (p<0.001). In LSA<90° group, mean correction was 20° at index level, 13° at L4-S1 and 21° for LSA versus 11°, 8° and 8° respectively in LSA>90° group (p<0.001). Fusion rate was estimated at 96.5%. One infection, 5 sympathetic dysfunctions, one retrograde ejaculation, one iliac vein injury, one incisional hernia, one lateral femoral cutaneous nerve injury and two adjacent syndromes have been noted. CA is an efficient technique for the treatment of isthmic spondylolisthesis of all grades, with an acceptable rate of complications. It allows a restoration of the regional lordosis as well as a foraminal widening, avoiding additional decompression.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Radiological Datamentioning

confidence: 99%

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Isthmic spondylolisthesis treated with circumferential arthrodesis (ALIF and posterior fixation): correction, fusion and indirect decompression

Khalifé¹,

Dauzac²,

Lenoir³

et al. 2021

Acta Orthop Belg

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“…The procedure can be used to treat diverse pathologies and has many benefits. Demonstrated radiographic advantages include effective restoration of disk height, reduction of spondylolisthesis, and improved spinopelvic parameters [ 2 , 3 ]. The approach allows for a complete discectomy and placement of a large interbody cage, resulting in solid anterior column support and fusion rates in excess of 90% [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…The approach allows for a complete discectomy and placement of a large interbody cage, resulting in solid anterior column support and fusion rates in excess of 90% [ 4 ]. The ALIF has also been associated with improved patient-reported outcome measures [ 2 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

A Technical Nuance to Avoid Lumbar Five Radiculopathy with Anterior Lumbar Fusion and Posterior Instrumentation

Neal

Kalani

Lyons

2021

Case Reports in Orthopedics

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The anterior lumbar interbody fusion (ALIF) is a well-established procedure used to treat a multitude of spinal pathologies. When performed at the L5-S1 level, the ALIF is often supplemented with posterior pedicle screw and rod fixation. Because the interbody device can restore disk and foraminal height, one benefit of the ALIF procedure is indirect neural decompression in the spinal canal and neural foramina. If the contour of the posterior rod is not matched to the exact position of the tulip heads on the pedicle screws, spondylolisthesis can be introduced, leading to foraminal stenosis and nerve compression. This concern is particularly germane when the posterior instrumentation is placed percutaneously without any direct foraminal decompression. In this report, we describe a patient who had an L4-S1 ALIF, resulting in new L5-S1 retrolisthesis and worsening L5 radiculopathy. Technical nuances and avoidance strategies are discussed.

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How I do it: mini invasive transforaminal lumbar interbody fusion

et al. 2020

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Circumferential minimally invasive approach for low-grade isthmic spondylolisthesis: A clinical and radiological study of 43 patients

Abstract: One stage circumferential fixation for adults' LGIS without decompression, allows restoration of intervertebral height permitting good reduction of the slippage, an increasing of the IFS and liberation of nerve roots.

Cited by 10 publications

References 18 publications

Isthmic spondylolisthesis treated with circumferential arthrodesis (ALIF and posterior fixation): correction, fusion and indirect decompression

Isthmic spondylolisthesis treated with circumferential arthrodesis (ALIF and posterior fixation): correction, fusion and indirect decompression

A Technical Nuance to Avoid Lumbar Five Radiculopathy with Anterior Lumbar Fusion and Posterior Instrumentation

How I do it: mini invasive transforaminal lumbar interbody fusion

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