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

 Jong Yeol Kim  ;  Jeong Yoon Park  ;  Kyung Hyun Kim  ;  Sung Uk Kuh  ;  Dong Kyu Chin  ;  Keun Su Kim  ;  Yong Eun Cho 
 World Neurosurgery, Vol.84(5) : 1284-1293, 2015 
Journal Title
 World Neurosurgery 
Issue Date
Bone Screws ; Disability Evaluation ; Female ; Humans ; Intervertebral Disc Degeneration/pathology ; Intervertebral Disc Degeneration/surgery ; Lumbar Vertebrae/pathology ; Lumbar Vertebrae/surgery* ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/methods* ; Neurosurgical Procedures/methods* ; Osteoporosis/complications ; Postoperative Complications/epidemiology ; Retrospective Studies ; Spinal Fusion/methods* ; Spondylolisthesis/pathology ; Spondylolisthesis/surgery* ; Tomography, X-Ray Computed ; Treatment Outcome
Degenerative spondylolisthesis ; Isthmic spondylolisthesis ; Minimally invasive surgery
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 rates were 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.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
구성욱(Kuh, Sung Uk) ORCID logo https://orcid.org/0000-0003-2566-3209
김경현(Kim, Kyung Hyun)
김근수(Kim, Keun Su) ORCID logo https://orcid.org/0000-0002-3384-5638
김종열(Kim, Jong Yul)
박정윤(Park, Jeong Yoon) ORCID logo https://orcid.org/0000-0002-3728-7784
조용은(Cho, Yong Eun) ORCID logo https://orcid.org/0000-0001-9815-2720
진동규(Chin, Dong Kyu) ORCID logo https://orcid.org/0000-0002-9835-9294
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