Clinical study on minimally invasive transforaminal lumbar interbody fusion surgery for lumbar spondylolisthesis combined with severe narrowing of the intervertebral space

J Int Med Res. 2020 Mar;48(3):300060519889458. doi: 10.1177/0300060519889458.

Abstract

Objective: To investigate the different clinical characteristics of minimally invasive transforaminal lumbar interbody fusion on treatment of lumbar spondylolisthesis combined with severe narrowing of the intervertebral space or simple grade II lumbar spondylolisthesis.

Methods: Thirty-eight patients were divided into groups A (16 cases combined with severe intervertebral space narrowing) or B (22 cases of simple grade II lumbar spondylolisthesis without intervertebral space narrowing). Differences in preoperative preparation, operation time, blood loss, tool selection, decompression, reduction, pedicle screw, cage size selection, and other aspects were compared. The Visual Analogue Scale (VAS) and Japanese Orthopaedic Association (JOA) scores were used to assess the effect of treatment.

Results: The operation time was significantly longer, blood loss was greater, the anatomical reduction rate was lower, and cage size was smaller in group A than in group B. Furthermore, special tools were required for treating the lumbar intervertebral space and the pedicle screws were different between the groups. JOA and VAS scores were similar between the groups

Conclusions: Cases of severe intervertebral space narrowing need to be fully released, with bilateral decompression, and special intervertebral processing tools need to be prepared. Long pedicle screws are conducive to connecting the rod and reducing slippage.

Keywords: Minimally invasive transforaminal lumbar interbody fusion; Visual Analogue Scale; cage; lumbar spondylolisthesis; narrowing of the intervertebral space; pedicle screw.

MeSH terms

  • Aged
  • Blood Loss, Surgical
  • Clinical Decision-Making
  • Disease Management
  • Female
  • Humans
  • Lumbar Vertebrae / pathology*
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures* / methods
  • Operative Time
  • Radiography
  • Severity of Illness Index
  • Spinal Fusion* / methods
  • Spondylolisthesis / diagnosis*
  • Spondylolisthesis / surgery*
  • Treatment Outcome