Abstract
This study aims to assess the difference between minimal invasive TLIF surgery and conventional TLIF surgery in cases of lytic spondylolisthesis, as regards pain, disability, hospital stay and complications. Lytic Spondylolisthesis patients may require fusion of one or more spinal segments to treat their condition adequately. The chances of achieving a successful lumbar spinal fusion has increased. TLIF technique is gradually being accepted in these cases and widely used by most spine surgeons. Minimal invasive TLIF is a recent trend for spinal fusion. This is a prospective randomized comparative study conducted from March 2016 to December 2018 included forty patients with low grade lytic spondylolisthesis that underwent surgeries. Twenty patients underwent MI-TLIF through percutaneous posterior lumbar pedicular screw fixation, microscopic minimally invasive transformational discectomy and interbody cage fusion (patients group “A”) and another twenty patients underwent traditional open posterior lumbar pedicular screw fixation and TLIF (control group “B”). In our results, both surgical techniques showed improvement in pain and function within 12 months (follow up period), but group A showed statistically significant improvement in pain and function in the 1<sup>st</sup> three months. Regarding blood loss, need for transfusion and hospital stay, group A showed statistically significant better results. As a conclusion, minimally invasive TLIF is a better option in surgical management of spondylolisthesis especially in the early postoperative period.
Highlights
Spinal fusion in the properly selected patient has been well demonstrated to be effective in improving pain, function, and quality of life
Twenty patients underwent MI-transforaminal lumbar interbody fusion (TLIF) through percutaneous posterior lumbar pedicular screw fixation, microscopic minimally invasive transforaminal discectomy and interbody cage fusion and another twenty patients underwent traditional open posterior lumbar pedicular screw fixation and TLIF. These two group were compared as regards low back pain and limb pain (Visual Analogue Score “VAS”), disability according to “Oswestry Disability Index – ODI”, hospital stay and peri-operative complications
Postoperative results data were obtained before hospital discharge, while late postoperative results data were obtained during follow up starting from 1st to 12th month
Summary
Spinal fusion in the properly selected patient has been well demonstrated to be effective in improving pain, function, and quality of life. Many patients resist having a surgical fusion due to concerns over the morbidity of the procedure [1]. Some patients require fusion of one or more spinal segments to treat their condition adequately. The chances of successful lumbar spinal fusion are increased significantly by the addition of a rigid fixation device [2]. In 1982, Harms and Rolinger described the transforaminal lumbar interbody fusion (TLIF) technique to create a 360-. Degree fusion via a single posterolateral approach [3]. In the TLIF procedure, bone graft and an interbody spacer are placed via a posterolateral transforaminal route into a distracted disc space in conjunction with a supplemental pedicle screw construct [4]
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