Minimally Invasive Transforaminal Lumbar Interbody Fusion for Spondylolisthesis: Comparison Between Isthmic and Degenerative Spondylolisthesis

被引:35
作者
Kim, Jong Yeol [1 ]
Park, Jeong Yoon [1 ]
Kim, Kyung Hyun [1 ]
Kuh, Sung Uk [1 ]
Chin, Dong Kyu [1 ]
Kim, Keun Su [1 ]
Cho, Yong Eun [1 ]
机构
[1] Yonsei Univ, Coll Med, Gangnam Severance Hosp, Dept Neurosurg,Spine & Spinal Cord Inst, Seoul, South Korea
关键词
Degenerative spondylolisthesis; Isthmic spondylolisthesis; Minimally invasive surgery; FOLLOW-UP; LONG-TERM; SPONDYLOLYTIC SPONDYLOLISTHESIS; CLINICAL-OUTCOMES; SLIP REDUCTION; ADULT; SPINE; DISC; COMPLICATIONS; INFECTION;
D O I
10.1016/j.wneu.2015.06.003
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
INTRODUCTION: Minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) is a common surgical option for degenerative spondylolisthesis (DS). However, its effectiveness for isthmic spondylolisthesis (IS) is still controversial. No current studies have directly compared perioperative and postoperative results including various radiological parameters between IS and DS after MIS TLIF. PURPOSE: The purpose of this study is to compare the clinical and radiological results between isthmic and degenerative spondylolisthesis after MIS TLIF. METHODS: This is a retrospective study of 41 patients who underwent MIS TLIF for single-segment, grade 1 or 2 IS (n = 18) and DS (n = 23). The same surgical techniques and procedure were applied to both groups. Perioperative outcomes (operation time, blood loss, hospital stay, complications); clinical outcomes (visual analog scale [VAS], Oswestry Disability Index [ODI]); radiological parameters (disk height, degree of spondylolisthesis, slip angle, lumbar lordosis, segmental lordosis, sacropelvic parameters: pelvic incidence, sacral slope, pelvic tile); and fusion rates using computed tomography scanning were compared between groups at 1 year postoperatively. RESULTS: There were no significantly different perioperative results between groups. Mean VAS and ODI scores improved significantly postoperatively in both groups but were not significantly different between groups at each follow-up point. Radiological parameters were not significantly different between groups except disk height and degree of spondylolisthesis. The disk heights were increased postoperatively (IS: 6.79-9.22 mm; DS: 8.18-8.97 mm) in both groups, and there were significant differences preoperatively. In addition, disk height restoration was greater for IS than DS (2.43 mm vs. 0.79 mm, P = 0.01). However, postoperative disk heights were not significantly different between groups. The degree of spondylolisthesis was significantly different between groups both preoperatively (16.77% vs. 11.33%, P < 0.01) and postoperatively (9.79% vs. 3.78%, P < 0.01). However, slip reduction was no different between groups (6.97 vs. 7.56%, P = 0.74). Fusion rateswere not significantly different between groups. CONCLUSIONS: MIS TLIF resulted in similar clinical outcomes when used to treat both isthmic and degenerative spondylolisthesis. Although disk height restoration was more effective for IS than DS, other radiological parameters including fusion rate were no different between groups. For both isthmic and degenerative spondylolisthesis, MIS TLIF can be a safe and effective surgical option.
引用
收藏
页码:1284 / 1293
页数:10
相关论文
共 47 条
  • [1] Contemporary management of isthmic spondylolisthesis: pediatric and adult
    Agabegi, Steven S.
    Fischgrund, Jeffrey S.
    [J]. SPINE JOURNAL, 2010, 10 (06) : 530 - 543
  • [2] TREATMENT OF SEVERE SPONDYLOLISTHESIS BY REDUCTION AND PEDICULAR FIXATION - A 4-6-YEAR FOLLOW-UP-STUDY
    BOOS, N
    MARCHESI, D
    ZUBER, K
    AEBI, M
    [J]. SPINE, 1993, 18 (12) : 1655 - 1661
  • [3] MANAGEMENT OF SEVERE SPONDYLOLISTHESIS IN CHILDREN AND ADOLESCENTS
    BOXALL, D
    BRADFORD, DS
    WINTER, RB
    MOE, JH
    [J]. JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1979, 61 (04) : 479 - 495
  • [4] Brantigan John W, 2003, Spine J, V3, P186, DOI 10.1016/S1529-9430(02)00536-3
  • [5] Lumbar interbody fusion using the Brantigan I/F Cage for posterior lumbar interbody fusion and the variable pedicle screw placement system - Two-year results from a Food and Drug Administration Investigational Device Exemption Clinical Trial
    Brantigan, JW
    Steffee, AD
    Lewis, ML
    Quinn, LM
    Persenaire, JM
    [J]. SPINE, 2000, 25 (11) : 1437 - 1446
  • [6] BRIDWELL KH, 1995, SPINE, V20, P1410, DOI 10.1097/00007632-199506000-00014
  • [7] Anatomical parameters of fifth lumbar vertebra in L5-S1 spondylolytic spondylolisthesis from a surgical point of view
    Choi, Hong-June
    Park, Jeong-Yoon
    Chin, Dong-Kyu
    Kim, Keun-Su
    Cho, Yong-Eun
    Kuh, Sung-Uk
    [J]. EUROPEAN SPINE JOURNAL, 2014, 23 (09) : 1896 - 1902
  • [8] Unilateral versus bilateral percutaneous pedicle screw fixation in minimally invasive transforaminal lumbar interbody fusion
    Choi, Un Yong
    Park, Jeong Yoon
    Kim, Kyung Hyun
    Kuh, Sung Uk
    Chin, Dong Kyu
    Kim, Keun Su
    Cho, Yong Eun
    [J]. NEUROSURGICAL FOCUS, 2013, 35 (02)
  • [9] deLoubresse CG, 1996, CLIN ORTHOP RELAT R, P194
  • [10] Deutsch Harel, 2006, Neurosurg Focus, V20, pE10