Transforaminal lumbar interbody fusion for traumatic lumbar spondylolisthesis

Abstract

To evaluate the clinical outcome, effectiveness and safety of the surgical management of traumatic lumbar spondylolisthesis with transforaminal lumbar interbody fusion (TLIF) with short segmental instrumentation fixation. A retrospective review of a consecutive series of 24 patients with traumatic lumbar spondylolisthesis treated with TLIF procedure was carried out. Intraoperative spinal cord monitoring was used to confirm the peripheral neural function intact during the reduction of the spondylolisthesis. Preoperative clinical and radiographic evaluation of all cases were originally collected prospectively. Data regarding blood loss, operative time, duration of hospital stay, radiographic fusion, instrumentation failure and clinical result were collected and observed at regular follow-up periods. All patients were engaged in high-energy accidents in the lower back and 16 patients had concomitant injuries. The mean operative time was 124 min, mean blood loss was 350 mL, and mean hospital stay was 6.5 days. There were no complications such as incision infection, cerebrospinal fluide (CSF) leakage and nerve root injury and so on. All patients demonstrated a solid lumbar interbody fusion within 4 months, and no evidence of spondylolisthesis correction loss, instrumentation failure and loosing. They all were completely asymptomatic, with normal neurologic findings, and had resumed their previous level of physical activities on the final follow-up. Meticulous clinical examination and careful imaging assessment could assist an early diagonosis in cases of traumatic lumbar spondylolisthesis. Performing open reduction and the TLIF procedure as soon as possible could restore segmental stability and painless function. The TLIF procedure was a safe, effective technique to treat traumatic lumbar spondylolisthesis.