Radiographic Analysis of Transforaminal Lumbar Interbody Fusion for the Treatment of Adult Isthmic Spondylolisthesis

Kwon, Brian K.; Berta, Scott C.; Daffner, Scott D.; Vaccaro, Alexander R.; Hilibrand, Alan S.; Grauer, Jonathan N.; Beiner, John M.; Albert, Todd J.

doi:10.1097/00024720-200310000-00006

Cited by 124 publications

(73 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Challenges with traditional techniques, such as posterior interbody fusion and transforaminal interbody fusion, can include anterior placement of the interbody cage, which can be crucial to the restoration of segmental lordosis. 15 Segmental lumbar lordosis is improved through the restoration of disc height with larger lordotic interbody cages such as is possible in both ALIF and MIS-LIF. 12 Marchi et al presented their case series on stand-alone lateral interbody fusion for lumbar listhesis with a significant improvement in lumbar lordosis and disc height, although their subsidence rate and revision surgery rate were 17% and 13%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive lateral retroperitoneal transpsoas interbody fusion for L4–5 spondylolisthesis: clinical outcomes

Ahmadian

Verma

Oskouian

et al. 2013

SPI

View full text Add to dashboard Cite

Object In this study the authors report on the clinical outcomes, safety, and efficacy of lateral retroperitoneal transpsoas minimally invasive surgery–lumbar interbody fusion (MIS-LIF) at the L4–5 disc space in patients with spondylolisthesis. This approach has become an increasingly popular means of fusion. Its most frequent complication is lumbar plexus injury. Reported complication rates at the L4–5 disc space vary widely in the literature, bringing into question the safety of MIS-LIF for the L4–5 region, especially in patients with spondylolisthesis. Methods The authors retrospectively reviewed prospectively acquired multicenter databases of patients with Grade I and II L4–5 spondylolisthesis who had undergone elective MIS-LIF between 2008 and 2011. Clinical follow-up had been scheduled for 1, 3, 6, 12, and 24 months postoperatively. Outcome measures included estimated blood loss, operative time, length of hospital stay, integrity of construct, complications, fusion rates, visual analog scale (VAS), Oswestry Disability Index (ODI), and 36-Item Short Form Health Survey (SF-36). Results Eighty-four patients with L4–5 MIS-LIF were identified, 31 of whom met the study inclusion criteria: 26 adults with Grade I and 5 adults with Grade II L4–5 spondylolisthesis who had undergone elective MIS-LIF and subsequent posterior percutaneous pedicle screw fixation without surgical manipulation of the posterior elements (laminectomy, foraminotomy, facetectomy). The study cohort consisted of 9 males (29%) and 22 females (71%) with an average age of 61.5 years. The mean total blood loss was 94 ml (range 20–250 ml). The mean hospital stay and follow-up were 3.5 days and 18.2 months, respectively. The average score on the ODI improved from 50.4 preoperatively to 30.9 at the last follow-up (p < 0.0001). The SF-36 score improved from 38.1 preoperatively to 59.5 at the last follow-up (p < 0.0001). The VAS score improved from 69.9 preoperatively to 38.7 at the last follow-up (p < 0.0001). No motor weakness or permanent deficits were documented in any patient. Correction of deformity did not have any neurological complications. All patients had improvement in anterolisthesis. Residual postoperative listhesis across cases was noted in 4 patients (12.9%). Transient anterior thigh numbness (Sensory Dermal Zone III) was noted in 22.5% of patients. Conclusions With its established surgical corridors through the retroperitoneum and psoas muscle, the MIS-LIF combined with posterior percutaneous pedicle screw fixation/reduction is a safe, reproducible, and effective technique for patients with symptomatic degenerative spondylolisthesis at the L4–5 vertebral segment.

show abstract

Section: Discussionmentioning

confidence: 99%

Minimally invasive lateral retroperitoneal transpsoas interbody fusion for L4–5 spondylolisthesis: clinical outcomes

Ahmadian

Verma

Oskouian

et al. 2013

SPI

View full text Add to dashboard Cite

show abstract

“…Recently, some studies have been reported on the topic of using TLIF to manage isthmic spondylolisthesis 2,9,15,19) . This approach allows exiting and traversing roots to be decompressed simultaneously, as well as stabilization of the anterior column from a single posterior approach.…”

Section: Discussionmentioning

confidence: 99%

“…This approach allows exiting and traversing roots to be decompressed simultaneously, as well as stabilization of the anterior column from a single posterior approach. Some investigators 9,15,19) have reported that lumbar lordosis could also be achieved and maintained by TLIF. According to other literature, TLIF has demonstrated its effectiveness in shortterm studies with less morbidity and expense to the patient than the combined ALIF 10,34) .…”

Section: Discussionmentioning

confidence: 99%

“…Several fusion methods have been reported for adult low-grade isthmic spondylolisthesis via various approaches including posterolateral fusion (PLF) 3,20) and lumbar interbody fusion techniques, such as posterior lumbar interbody fusion (PLIF) 5,7,22) , transforaminal interbody fusion (TLIF) 2,9,15,19) , anterior lumbar interbody fusion (ALIF) 11,21) , and a combined posterioranterior approach (circumferential fusion, 360 degree fusion) 4,12,16,31,33) , using different approaches, vertebral fixation modalities 35) , and fusion materials 7) . However, the choice of lumbar fusion technique must be individualized based on the clinical needs of each patient, the surgical outcomes for each procedure based on published literature, and the individual skills and the surgeon's preference.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Kim

Lee

2009

J Korean Neurosurg Soc

View full text Add to dashboard Cite

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.

show abstract

“…According to report the clinical success rate of modern bilateral posterolateral fusion (PLF) is about 81-100% and 60-98% clinical success rate [16,17] incomparisionto the rate of transpedicular fixation [18].…”

Section: Introduction Backgroundmentioning

confidence: 99%

Comparison of Simple Lumbar Interbody Fusion with CircumferentialFusion for Treatment of Isthmic Spondylolisthesis

Akter¹,

Hasan²,

Sana³

et al. 2017

Orthop Muscular Syst

View full text Add to dashboard Cite

Purpose: Spondylolisthesis is a common cause of surgery in patients with lower back pain. Although interbody fusion and circumferential fusion are a relatively common surgical method for the treatment of spondylolisthesis, we retrospectively compared surgical reduction or fusion in situ with simple lumbar interbody fusion (PLIF/TLIF) and circumferential fusion (PLF+TLIF/PLIF) for adult isthmic spondylolisthesis in terms of surgical invasiveness, clinical and radiographical outcomes, and complications.Methods: From January 2013 to June 2015, 84 adult patients with isthmic spondylolisthesis who underwent surgical treatment in our department were randomized to simple lumbar interbody fusion (PLIF/TLIF) group (group 1, n=45) and circumferential fusion (PLF+TLIF/PLIF) group (group 2, n=39), and followed up for average 28.6 months (range 24-54 months). All patients of both groups had low back pain as their predominant symptom, with varying degree of radicular pain and neurological symptoms. The data collected retrospectively for analysis were: duration of symptoms, levels of fusion, revision surgery, clinical and radiographic results after surgery, and complications. Results:All the 84 patients compared in two surgical approaches for IS were included in this retrospective studies. In our analysis, for the surgical management of isthmic spondylolisthesis, we indicated that both approaches lumbar interbody fusion (PLIF/TLIF) and circumferential fusion (PLF+TLIF/PLIF) have equal significant, greater fusion rates with successful clinical outcomes. Conclusion:Our clinical experience along with statistic findings indicates that in conclusion, there was no significant difference was found between simple interbody fusion (PLIF/TLIF) compared to circumferential fusion (PLF+TLIF/PLIF). Moreover, both techniques led to similar surgical outcomes and complication during follow-up. Thus, these results suggest that both procedures are equally effective for the treatment of isthmic spondylolisthesis. Keywords: Introduction BackgroundSpinal fusion technique was introduced 70 years ago for the treatment of degenerative disc disease and chronic lower back pain [1]. Hibbs and Albee were two spine surgeons in 1911, who performed first spinal stabilization surgery [2,3]. Forward displacement of a vertebral bone in sequence of normal alignment of vertebra is called Isthmic Spondylolisthesis-most commonly due to progressive vertebral body malalignment in the lumbar region of spine. Even in severe case of spondylolisthesis, the slipped vertebra is comfortably reduced by the modern surgical techniques [4][5][6][7].However, these operations have high risk of neurological complications from the implant and screws, even in correct procedure, there areneurological complications [8]. There are no significant neurological complication differences found between the reduction procedure and fusion situ [5,[8][9][10]. About 90% of all vertebral body slips due to the degenerative and isthmic types of spondylolisthesis [11]. Generally in populati...

show abstract

Radiographic Analysis of Transforaminal Lumbar Interbody Fusion for the Treatment of Adult Isthmic Spondylolisthesis

Cited by 124 publications

References 11 publications

Minimally invasive lateral retroperitoneal transpsoas interbody fusion for L4–5 spondylolisthesis: clinical outcomes

Minimally invasive lateral retroperitoneal transpsoas interbody fusion for L4–5 spondylolisthesis: clinical outcomes

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

Comparison of Simple Lumbar Interbody Fusion with CircumferentialFusion for Treatment of Isthmic Spondylolisthesis

Contact Info

Product

Resources

About