Outcome of transforaminal lumbar interbody fusion in spondylolisthesis—A clinico-radiological correlation

Balasubramanian, Vijay Anand; Douraiswami, Balaji; Suresh, Santhanam

doi:10.1016/j.jor.2018.02.017

Cited by 7 publications

(9 citation statements)

References 17 publications

(12 reference statements)

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“…[ 36 ] Furthermore, a recent study by Balasubramanian et al also did not observe a positive effect of reduction grade on the outcome in patients undergoing TLIF. [ 37 ]…”

Section: Discussionmentioning

confidence: 99%

Patient reported outcomes after navigated minimally invasive hybrid lumbar interbody fusion (nMIS-HLIF) using cortical bone trajectory screws

et al. 2022

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Prospective observational study. To evaluate patient-reported outcomes after navigation-guided minimally invasive hybrid lumbar interbody fusion (nMIS-HLIF) for decompression and fusion in degenerative spondylolisthesis (Meyerding grade I-II). Posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) are well-known standard procedures for lumbar spinal fusion. nMIS-HLIF is a navigation-guided combined percutaneous and open procedure that combines the advantages of PLIF and TLIF procedures for the preparation of a single-port endoscopic approach. 33 patients underwent nMIS-HLIF. Core outcome measure index (COMI), oswestry disability index (ODI), numeric rating scale (NRS) back, NRS leg, and short form health-36 (SF-36) were collected preoperatively and at follow-up of 6 weeks, 3 months, 6 months, and 1 year. The impact of body mass index (BMI) was also analyzed. Computed tomography reconstruction was used to assess realignment and verify fused facet joints and vertebral bodies at the 1-year follow-up. 28 (85%) completed the 1-year follow-up. The median BMI was 27.6 kg/m2, age 69 yrs. The mean reduction in listhesis was 8.4% (P < .01). BMI was negatively correlated with listhesis reduction (P = .032). The improvements in the NRS back, NRS leg, ODI, and COMI scores were significant at all times (P < .001—P < .01). The SF-36 parameters of bodily pain, physical functioning, physical component summary, role functioning/physical functioning, and social functioning improved (P < .003). The complication rate was 15.2% (n = 5), with durotomy (n = 3) being the most frequent. To reduce the complication rate and allow transitioning to a fully endoscopic approach, expandable devices have been developed. The outcomes of nMIS-HLIF are comparable to the current standard open and minimally invasive techniques. A high BMI hinders this reduction. The nMIS-HLIF procedure is appropriate for learning minimally invasive dorsal lumbar stabilization. The presented modifications will enable single-port endoscopic lumbar stabilization in the future.

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“…[ 36 ] Furthermore, a recent study by Balasubramanian et al also did not observe a positive effect of reduction grade on the outcome in patients undergoing TLIF. [ 37 ]…”

Section: Discussionmentioning

confidence: 99%

Patient reported outcomes after navigated minimally invasive hybrid lumbar interbody fusion (nMIS-HLIF) using cortical bone trajectory screws

et al. 2022

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“…In terms of the long-term outcome, radiographic outcome parameters are not clearly connected with clinical outcome parameters yet. [15][16][17][18][19][20] Recently published results of 3-year follow-up outcome data of patients suffering from degenerative spondylolisthesis who underwent lumbar spinal fusion surgery showed that reduction of the sagittal rotation and the sacral inclination correlates with an improvement of clinical outcome scores collected by the Core Outcome Measure Index (COMI) and the Oswestry Disability Index (ODI). 21 This study sought to identify and define radiological parameters that are associated with a beneficial long-term clinical outcome 6 years after surgery.…”

Section: Introductionmentioning

confidence: 99%

Long‐term Radiological and Clinical Outcome after Lumbar Spinal Fusion Surgery in Patients with Degenerative Spondylolisthesis: A Prospective 6‐Year Follow‐up Study

Bredow

Meyer

Oikonomidis

et al. 2022

Orthopaedic Surgery

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Objective To assess which radiological alignment parameters are associated with a satisfactory long‐term clinical outcome after performing lumbar spinal fusion for treating degenerative spondylolisthesis. Methods This single‐center prospective study assessed the relation between radiological alignment parameters measured on standing lateral lumbar spine radiographs and the patient‐reported outcome using four different questionnaires (COMI, EQ‐5D, ODI and VAS) as primary outcome measures (level of evidence: II). The following spinopelvic alignment parameters were used: gliding angle, sacral inclination, anterior displacement, sagittal rotation, lumbar lordosis, sacral slope, pelvic tilt and pelvic incidence. Furthermore, the length of stay and perioperative complications were documented. Only cases from 2013 to 2015 of low‐grade degenerative lumbar spondylolisthesis (Meyerding grades I and II) were considered. The patients underwent open posterior lumbar fusion surgery by pedicle screw instrumentation and cage insertion. The operative technique was either a posterior lumbar interbody fusion (PLIF) or a transforaminal lumbar interbody fusion (TLIF) performed by three different senior orthopedic surgeons. Exclusion criteria were spine fractures, minimally invasive techniques, underlying malignant diseases or acute infections, previous or multisegmental spine surgery as well as preoperative neurologic impairment. Of 89 initially contacted patients, 17 patients were included for data analysis (11 males, six females). Results The data of 17 patients after mono‐ or bisegmental lumbar fusion surgery to treat low‐grade lumbar spondylolisthesis and with a follow‐up time of least 72 months were analyzed. The mean age was 66.7 ± 11.3 years. In terms of complications two dural tears and one intraoperative bleeding occurred. The average body mass index (BMI) was 27.6 ± 4.4 kg/m 2 and the average inpatient length of stay was 12.9 ± 3.8 days (range: 8–21). The long‐term clinical outcome correlated significantly with the change of the pelvic tilt ( r s = −0.515, P < 0.05) and the sagittal rotation ( r s = −0.545, P < 0.05). The sacral slope was significantly associated with the sacral inclination ( r s = 0.637, P < 0.01) and the pelvic incidence ( r s = 0.500, P < 0.05). In addition, the pelvic incidence showed a significant correlation with the pelvic tilt ( r s = 0.709, P < 0.01). The change of the different clinical scores over time also correlated significantly between the different questionnaires. Conclusions The surgical modification of the pelvic tilt and...

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“…7 In a study by Balasubramanian et al, clinical and radiological correlations were performed and the study showed that 85% of the participants showed good clinical outcome at the end of 1 year. 8 Previously available literature has shown that symptomatic lumbar spondylolisthesis and spondylolysis can be efficiently managed by TLIF. 5 7 9 10 There is a gap in the available literature regarding the functional outcome of the patient in the postoperative period.…”

Section: Introductionmentioning

confidence: 99%

Study on Outcome Analysis of Transforaminal Interbody Fusion with Transpedicular Screws and Rods in Lumbar Spondylolisthesis and Spondylolysis

Mahantshetti

Soraganvi

Raju

2022

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Introduction The management of spondylolisthesis and spondylolysis is primarily conservative or surgical. There are various surgical procedures available for spondylolisthesis. Objective To evaluate the functional outcome and efficacy in patients undergoing transforaminal lumbar interbody fusion with transpedicular screws and rods in symptomatic lumbar spondylolisthesis and spondylolysis. Methods From 2017 to 2018, a prospective observational study was performed in a tertiary care hospital. The preoperative evaluation was performed both clinically and radiologically. Based on indications, transforaminal interbody fusion was performed. A total sample of 20 patients was included. The primary outcome variables were the visual analogue scale (VAS), the Oswestry Disability Index (ODI), slip percentage, and disc height at follow-up. For the statistical analysis, coGuide (BDSS CORP, Bangalore, Karnataka, India) was used. Results In 20 participants studied, the mean age was 48.25 ± 5.35 years old. Degenerative spondylolisthesis was seen in 60% of the participants. The majority (70%) of the patients had grade 2 slips. The mean difference of the VAS, the ODI, slip percentage, and disc height between the preoperative and postoperative periods was statistically significant (p < 0.001). The majority (70%) of the patients had no complications after the procedure. Conclusions Transforaminal interbody fusion with pedicle screws and rods is a safe, simple procedure and has less morbidity. This procedure also provides better functional outcomes and reduction in symptoms by maintaining the disc height and providing sagittal balance.

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Outcome of transforaminal lumbar interbody fusion in spondylolisthesis—A clinico-radiological correlation

Abstract: TLIF produces spinal fusion in most individuals. Strong spinal fusion is essential for good clinical outcome in spondylolisthesis patients who undergo TLIF. Reduction in slip is not necessary for all patients with listhesis.

Cited by 7 publications

References 17 publications

Patient reported outcomes after navigated minimally invasive hybrid lumbar interbody fusion (nMIS-HLIF) using cortical bone trajectory screws

Patient reported outcomes after navigated minimally invasive hybrid lumbar interbody fusion (nMIS-HLIF) using cortical bone trajectory screws

Long‐term Radiological and Clinical Outcome after Lumbar Spinal Fusion Surgery in Patients with Degenerative Spondylolisthesis: A Prospective 6‐Year Follow‐up Study

Study on Outcome Analysis of Transforaminal Interbody Fusion with Transpedicular Screws and Rods in Lumbar Spondylolisthesis and Spondylolysis

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