Minimal Invasive Transforaminal Lumbar Interbody Fusion in Low Grade Isthmic Spondylolithesis

Selim, Elsayed Mohamed; El-Hewala, Tarek; El-Adawy, Amr Mohamed; Kelany, Omar Mohamed Abd Elwahab

doi:10.21608/zumj.2020.24340.1748

Minimal Invasive Transforaminal Lumbar Interbody Fusion in Low Grade Isthmic Spondylolithesis

Document Type : Original Article

Authors

¹ Orthopedicdepartment, faculity of medicine ,zagazig univeristy , zagazig, Egypt.

² Orthopedic department, faculity of medicine, zagazig univeristy, zagazig, Egypt

³ Orthopedic department Zagazig univeristy hospitals

10.21608/zumj.2020.24340.1748

Abstract

Abstract
Study Design:Prospective clinical trial
Aim: To evaluate the results of Minimal Invasive Lumbar Interbody Fusion (MIS-TLIF) in management of Isthmic spondylolisthesis
Introduction:Symptomatic isthmic spondylolisthesis may cause back and or leg pain that usually need surgical intervention. The question is what type of surgical treatment option to choose; a good option is MIS-TLIF with similar or to somewhat better results than the traditional open-TLIF.
Methods:Between December 2017 to December 2019, 24 patients having low-grade isthmic spondylolisthesis were subjected to MI-TLIF surgery in the spine unit of orthopedic department Zagazig university hospital. Osteotomy of the facet complex, preparation of the disc space and cages insertion was done, with per-cutaneous pedicle screw fixation. Demographic data, radiological imaging, Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were collected. Twelve months was the least follow up period.
Results: The mean slip reduction changed from 23.13% to 6.48%. The mean VAS for back and leg pain improved from8.42 to 1.79 and7.46 to 1 respectively. The mean ODI decreased from 52.21 to 15.71 at the final outcome. No implant failure was documented in our patients. Our mean operative time was 110. 20 ± 13.39 minute, our mean radiation exposure was 3.79 ± 0.83 minute and the mean blood loss was 56.45 ± 14.63 ml. The fusion rate was 95.8%.
Conclusion:MIS-TLIF for low-grade isthmic spondylolisthesis provided us with good clinical outcome and good fusion rate. MIS-TLIF can restore and maintain an adequate Sagittal Vertical Access (SVA) and so can provide us with good sagittal alignment post-operative.

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