TRANSFORAMINAL LUMBAR INTERBODY FUSION in the MANAGEMENT of LYTIC SPONDYLOLITHESIS: MINIMALLY INVASIVE VERSUS CONVENTIONAL OPEN TECHNIQUES (original) (raw)
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Minimally Invasive Versus Open TLIF in the Management of Lumbar Spondylolisthesis
International Journal of Neurosurgery, 2020
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 st 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.
International Journal of Orthopaedics Sciences, 2018
Introduction: Spondylolisthesis is defined as the forward displacement of one vertebra over the vertebra below. It is often accompanied by spinal canal stenosis and compression, which is the cause of all the symptoms. Aim: The aim of this prospective study is to analyze the Functional outcome of Transforaminal Lumbar Interbody Fusion in Spondylolisthesis. Methods: 20 patients of Isthmic spondylolisthesis grade I-III, patients who don't respond to conservative treatment (6 months), Degenerative spondylolisthesis grade I-II, patients who don't respond to conservative treatment (6 months), Traumatic spondylolisthesis were included in this study. Results: The most common level involved is L4-L5 in 55% of cases and L5-S1 in 40% of cases. The L4-L5 Level is most commonly affected in Degenerative type (80%). The L5-S1 level was most commonly affected in Lytic type (60%). The mean preoperative Visual analog score for Back pain was 10 which improved to 2(1-4) at final follow up implying better pain score postoperatively. The mean preoperative Visual analog score for Leg pain was 8 which improved to 1 (1-5) at final follow up implying better pain score postoperatively. The mean preoperative Oswestry Disability Index (ODI) Score was 64% (range from 56%-74%) which improved to 20% at final follow up which indicates improvement in daily activities of the patient. Conclusion: Transforaminal Lumbar Interbody Fusion is a safe and effective surgical procedure for the treatment of lytic and degenerative spondylolisthesis.
Bratislavské lekárske listy, 2021
BACKGROUND: Lumbar spondylolisthesis is a relatively common cause of low back and lower extremity pain. The most common type, degenerative lumbar spondylolisthesis (DLS), is a disease that causes stenosis of the spinal canal. Two surgical methods of treatment are widely accepted, namely posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF). MATERIALS AND METHODS: Between 2015 and 2017, the fi ndings of 333 consecutive DLS patients who underwent surgical decompression with instrumented fusion were analyzed in a prospective study at the
Journal of Orthopaedics, 2018
Introduction: Lumbar spondylolisthesis is a common cause of morbidity in middle aged individuals. Spinal fusion with instrumentation has become the gold standard for lumbar segmental instability. Studies which correlate the improvement in radiology postoperatively with functional outcome show contrasting reports. This study is aimed at finding the correlation between clinical and radiological outcomes after surgery with transforaminal lumbar interbody fusion. Methods: A retrospective study in 35 patients who underwent transforaminal lumbar interbody fusion in a period of 1 year was done. Preoperative pain (VAS Score), functional ability (ODI), radiological parameters (slip angle, slip grade, disc height, foraminal height, lumbar lordosis) were compared with postoperative recordings at the last followup. Functional improvement (Macnab's criteria) and fusion (Lee's fusion criteria) were assessed. Statistical analysis was done with student's paired t-test and Pearson's correlation coefficient. Results: VAS score, ODI improved from 8 to 2 and 70 to 15 respectively. Slip angle improved from 23°to 5°on an average. 80% patients showed fusion and 85% showed good clinical outcome at 1 year followup. Analyzing with Pearson correlation coefficient showed no significant relation between pain scores and radiological parameters. But there was statistically significant relation between radiological fusion and the final clinical outcome. Conclusion: 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.
Lumbar fusion for lytic spondylolisthesis: Is an interbody cage necessary?
Journal of craniovertebral junction & spine
This study was a retrospective observational study. The purpose of the study was to determine the radiological and clinical outcome of using locally sourced autologous bone graft in the surgical management of single-level lumbar lytic spondylolisthesis. Many spinal surgeons supplement pedicle screw fixation of lumbar spondylolisthesis with cages. In developing countries, the high cost of interbody cages has precluded their use, with surgeons resorting to filling the interbody space with different types of bone graft instead. This study reports on the clinical and radiological outcome of posterior lumbar interbody fusions for low-grade lytic spondylolisthesis using locally sourced autologous bone graft. Posterior interbody fusion was performed in 22 consecutive patients over 18-month period, using (BRAND) pedicle screw system and locally sourced bone graft, i.e., bone removed during neural decompression. There were no postoperative restrictions, and all patients underwent clinical ou...
Scholars Journal of Applied Medical Sciences
Objective: In this study our main goal is to compare the efficiency of posterior lumbar interbody fusion (FLIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of spondylolisthesis. Method: This experimental observational type study was carried out at Bangabandhu Sheikh Mujib Medical University and different private hospital in Dhaka from July, 2006 to December 2019. A total number of 340(PLIF=150, TLIF=190) patients underwent lumbar interbody fusion with pedicle screw fixation for the treatment of adult lumbar spondylolisthesis were taken as a study sample. Results: During the study, surgical outcomes between PLIF and TLIF where there were significant differences between the groups in relation to VAS for back pain. These variables were significantly higher in the TLIF group compared to the PLIF group. There was no significant difference between the two groups with respect to VAS for leg pain at final follow-up. However prevalence of Nerve Root injury,Dural tearan...
Open Access Macedonian Journal of Medical Sciences
BACKGROUND: The safety and efficacy of transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF) in lumbar spondylolisthesis have not been validated in many prospective randomized trials. AIM: We aimed to validate the safety and efficacy of TLIF and PLIF surgery in lumbar spondylolisthesis using the clinical, radiographic, and cost-utility outcomes. METHODS: The data of surgically treated single-level spondylolisthesis patients were randomized prospectively into two groups. The groups were compared regarding demographics, perioperative complications, hospital stay, total expenditure, fusion rate, and clinical outcomes (visual analog scale, Oswestry disability index, Zurich claudication scale, and Odom’s criteria). A review of literature was done to compare the outcomes with the ones from higher-income nations. RESULTS: Thirty-three patients underwent prospective randomization. The improvement in the clinical outcomes at 12-month follow-up showed impr...