Comparison between Instrumented Mini-TLIF and Instrumented Circumferential Fusion in Adult Low-Grade Lytic Spondylolisthesis : Can Mini-TLIF with PPF Replace Circumferential Fusion?

Abstract

consecutive patients underwent instrumented circumferential fusion (group II) at Leon Wiltse Memorial Hospital, Suwon, Korea. The mean follow-up periods were 29.7 and 26.1 months, respectively. Results : Mean visual analog scale (VAS) scores for back and leg pain decreased, respectively, from 6.98 and 6.33 to 2.3 and 2.2 in group I and from 7.38 and 6.00 to 1.7 and 1.0 in group II. Mean Oswestry disability index (ODI) improved from 51.85% to 14.4% in group I and from 60% to 9.1% in group II. In both groups, VAS and ODI scores significantly changed from pre-to postoperatively (p<0.001), but postoperative outcome between groups was statistically not significant. Radiologic evidence of fusion was noted in 95.7% and 100% of the patients in group I and II, respectively. In both groups, changes in disc height, segmental lordosis, degree of listhesis, and whole lumbar lordosis between the pre-and postoperative periods were significant except whole lumbar lordosis in both groups. Conclusion :Clinical and functional outcomes demonstrate no significant differences between groups in treating back and leg pain of adult patients with low-grade isthmic spondylolisthesis. However, in terms of operative data (i.e. operation time and hospital stay), instrumented mini-TLIF demonstrated better results.

Effects on Clinical Outcomes of Grafts and Spacers Used in Transforaminal Lumbar Interbody Fusion: a Critical Review

“…In all, we included 29 papers in our review. We classified the modalities materials used for fusion according to cage or spacer type and source of graft and/or bone extender used and calculated data for each independently.…”

“…Studies have shown TLIF to be superior to both anterior‐posterior fusion and posterior lumbar internal fixation for treating symptomatic disc degeneration, as well as a suitable procedure for correcting both isthmic spondylolisthesis and adult degenerative scoliosis. The procedure has even evolved to having a minimally invasive option that has also proven to be effective and, for some indications, even more effective than traditional TLIF. There have been numerous published reports assessing the efficacy of cage and screw placement, use of recombinant human bone morphogenetic protein 2 (rhBMP‐2) and other factors thought to contribute to successful fusion.…”

Une série continue de 27 patients adultes opérés d’un spondylolisthésis isthmique L5-S1 par voie combinée : résultats cliniques et radiologiques à 1 an de suivi

“…Le traitement du spondylolisthésis par lyse isthmique de l'adulte repose, le plus souvent, sur l'arthrodèse instrumentée de l'étage olisthésique. Celle-ci peut être obtenue via un abord postérieur par arthrodèse postérolatérale (PLF) [8,9] ou intersomatique par voie postérieure (PLIF) [8,9], par voie transforaminale (TLIF) [10,11] via un abord antérieur (ALIF) [12,13] ou par une approche combinée, antérieure et postérieure (arthrodèse circonférentielle) [14][15][16][17][18][19].…”

In defense of minimally invasive spine surgery

“…[21,22] There have been multiple authors describing MIS techniques for various indications that have shown equivalent fusion rates and functional outcomes compared with standard open procedures. [18,[23][24][25] Wang et al have reported on the successful application of MIS fusion techniques to treat adult spinal deformities. [26] In a review of 42 patients, Dhall et al [27] open group (P < 0.01).…”