Mini-Open Versus Conventional Open Posterior Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Spondylolisthesis

Tsutsumimoto, Takahiro; Shimogata, Mitsuhiko; Ohta, Hiroshi; Misawa, Hiromichi

doi:10.1097/brs.0b013e3181a9d28e

Cited by 132 publications

(107 citation statements)

References 32 publications

(18 reference statements)

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“…Two studies in our systematic review did demonstrate improved early outcome scores in MIS PLIF over open PLIF; however, this effect was noticed during the early timeframe postoperatively and became negligible at [ 1-year followup. However, five studies did not find a benefit to MIS PLIF over open PLIF in terms of validated outcomes scores [4,11,20,26,28]. This suggests MIS may result in a quicker decrease in postoperative pain and functional recovery, but no studies in our review evaluated return to work status for patients.…”

Section: Discussionmentioning

confidence: 77%

“…Compared with posterolateral and lateral approaches, PLIF may be advantageous, providing a wider area of intervertebral interbody graft bone contact surface, improved load-sharing, adequate access for complete decompression of the neural elements, restoration of neural foraminal height, and the ability to restore segmental lordosis at the involved level [1-3, 5, 10]. Multiple studies report a high fusion rate ranging between 89% and 97% with this technique [4,7,11,18,26,30,32].…”

Section: Introductionmentioning

confidence: 99%

“…Multiple studies report a high complication rate during the learning stage [6,16,23]. Recently, a number of comparative studies have compared the effectiveness of open PLIF and MIS PLIF for degenerative spinal conditions [4,7,11,18,20,26,28]. However, consensus regarding superiority of either approach is lacking as a result of inconsistent conclusions in the various studies.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Minimally Invasive versus Open Posterior Lumbar Interbody Fusion: A Systematic Review

Sidhu

Henkelman

Vaccaro

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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BackgroundAlthough conventional open posterior lumbar interbody fusion (open PLIF) is efficacious in management of lumbar spinal instability, concerns exist regarding lengthy hospital stays, blood loss, and postoperative complications. Minimally invasive posterior lumbar interbody fusion (MIS PLIF) may be able to address these concerns, but the research on this topic has not been systematically reviewed. Questions/purposes We performed a systematic review to determine whether MIS PLIF or open PLIF results in (1) better perioperative parameters, including blood loss, operative times, and length of hospital stay; (2) improved patient-reported outcome scores; and (3) improved disc distraction and (4) frequency of reoperation and complications when compared with open PLIF procedures. Methods A literature search of the MEDLINE database identified seven studies that met our inclusion criteria. A total of seven articles were included; quality was assessed using the Methodological Index for Non-Randomised Studies (MINORS) scale. Descriptive statistics were used to describe the included articles.

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Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Minimally Invasive versus Open Posterior Lumbar Interbody Fusion: A Systematic Review

Sidhu

Henkelman

Vaccaro

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…An advantage of minimally invasive spine surgery (MIS) is that it reduces paraspinal muscular injury. Previous studies comparing MIS and conventional surgical techniques showed that MIS caused less damage to the paraspinal muscle, as determined by assessing the degree of atrophy and T2-signal intensity [6,10,[12][13][14]. However, some controversy remains as to whether the advantages of MIS are reflected by improved clinical outcomes, as assessed using measures such as VAS scores for low back pain, the Oswestry disability index, or the JOA score [6,10,[12][13][14].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, unilateral laminotomy for bilateral decompression of lumbar spinal stenosis is expected to preserve the paraspinal muscles on the contralateral side of the approach [8]. The Wiltse et al [9] approach for insertion of pedicle screws (PSs) is also considered a less invasive technique that helps preserve paraspinal musculature [10]. A major advantage of all these techniques is the reduction in iatrogenic paraspinal muscular injury, because damage to these muscles, can lead to denervation and atrophy and thus increased the risk of ''fusion disease'' [1,11].…”

Section: Introductionmentioning

confidence: 99%

Spinous process-splitting open pedicle screw fusion provides favorable results in patients with low back discomfort and pain compared to conventional open pedicle screw fixation over 1 year after surgery

et al. 2012

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Introduction The conventional open pedicle screw fusion (PSF) requires an extensive detachment of the paraspinal muscle from the posterior aspect of the lumbar spine, which can cause muscle injury and subsequently lead to ''approachrelated morbidity''. The spinous process-splitting (SPS) approach for decompression, unilateral laminotomy for bilateral decompression, and the Wiltse approach for pedicle screw insertion are considered to be less invasive to the paraspinal musculature. We investigated whether SPS open PSF combined with the abovementioned techniques attenuates the paraspinal muscle damage and yields favorable clinical results, including alleviation in the low back discomfort, in comparison to the conventional open PSF. Methods We studied 53 patients who underwent singlelevel PSF for the treatment of degenerative spondylolisthesis (27 patients underwent SPS open PSF and the other 26 underwent the conventional open PSF). The clinical outcomes were assessed using the Japanese Orthopedic Association (JOA) score, the Roland-Morris disability questionnaire (RDQ), and the visual analog scale (VAS) for low back pain and low back discomfort (heavy feeling or stiffness). Postoperative multifidus (MF) atrophy was evaluated using MRI. Follow-up examinations were performed at 1 and 3 years after the surgery.Results Although there was no significant difference in the JOA and RDQ score between the two groups, the VAS score for low back pain and discomfort after the surgery were significantly lower in the SPS open PSF group than in the conventional open PSF group. The extent of MF atrophy after SPS open PSF was reduced more significantly than after the conventional open PSF during the follow-up. The MF atrophy ratio was found to correlate with low back discomfort at the 1-year follow-up examination. ConclusionIn conclusion, SPS open PSF was less damaging to the paraspinal muscle than the conventional open PSF and had a significant clinical effect, reducing low back discomfort over 1 year after the surgery.

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Surgical options for lumbar spinal stenosis

Machado

Ferreira

Yoo

et al. 2016

Cochrane Database of Systematic Reviews

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The most common reason for spinal surgery in elderly patients is lumbar spinal stenosis (LSS). For LSS, treatment decisions based on clinical and radiological information as well as personal experience of the surgeon shows large variance. Thus a standardized support system is of high value for a more objective and reproducible decision. In this work, we develop an automated algorithm to localize the stenosis causing the symptoms of the patient in magnetic resonance imaging (MRI). With 22 MRI features of each of five spinal levels of 321 patients, we show it is possible to predict the location of lesion triggering the symptoms. To support this hypothesis, we conduct an automated analysis of labeled and unlabeled MRI scans extracted from 788 patients. We confirm quantitatively the importance of radiological information and provide an algorithmic pipeline for working with raw MRI scans.

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Mini-Open Versus Conventional Open Posterior Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Spondylolisthesis

Abstract: Mini-open PLIF is safe and effective. Mini-open PLIF was less invasive than open PLIF with regard to the MF muscle.

Cited by 132 publications

References 32 publications

Minimally Invasive versus Open Posterior Lumbar Interbody Fusion: A Systematic Review

Minimally Invasive versus Open Posterior Lumbar Interbody Fusion: A Systematic Review

Spinous process-splitting open pedicle screw fusion provides favorable results in patients with low back discomfort and pain compared to conventional open pedicle screw fixation over 1 year after surgery

Surgical options for lumbar spinal stenosis

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