Minimally Invasive Transforaminal Lumbar Interbody Fusion (TLIF) for Spondylolisthesis in 282 Patients: In Situ Arthrodesis versus Reduction

Justin K. Scheer, Brenda Auffinger, Ricky H. Wong, Sandi K. Lam, Cort D. Lawton, Alexander T. Nixon, Nader S. Dahdaleh, Zachary A. Smith*, Richard G. Fessler

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Objective The benefits of spondylolisthesis reduction via minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) remain poorly understood. The purpose was to compare the complications, perioperative factors, and fusion rates in patients undergoing MI-TLIF for degenerative spondylolisthesis between those in whom reduction was or was not performed. Methods Inclusion criteria: 1) patients who underwent a 1, 2, or 3 level MI-TLIF and 2) had a preoperative diagnosis of degenerative spondylolisthesis (Meyerding grade >0). Exclusion criteria: >10° coronal curves, significant sagittal malalignment, infection, and preoperative hardware failure. Patients were grouped on the basis of those who underwent reduction of the spondylolisthesis by at least 1 Meyerding grade (RED) and those who did not (NORED). Results A total of 282 patients were included: RED (162, 57.4%) and NORED (120, 42.6%). Mean ages (61.68 ± 10.43 vs. 61.88 ± 11.76 years, respectively, P > 0.05) and operative times (P > 0.05) were statistically similar. RED had a significantly larger EBL (280.2 ± 24.03 vs. 212.61 ± 17.54, P < 0.05). The length of hospital stay, intraoperative complications, postoperative medical and surgical complications, and disposition were statistically similar between groups (P > 0.05, for all). RED had a significantly higher percentage of patients with a successful fusion at 1 year than NORED (84.50% vs. 70.83%, P < 0.05). Conclusion Reduction of spondylolisthesis was not associated with an increase in operative time, length of stay, and perioperative and postoperative complications compared with fusion in situ. Reduction was associated with higher blood loss but also a higher rate of fusion success at 1 year. Overall, reduction did not incur additional risk and had positive perioperative outcomes.

Original languageEnglish (US)
Pages (from-to)108-113
Number of pages6
JournalWorld neurosurgery
Volume84
Issue number1
DOIs
StatePublished - Jul 1 2015

Keywords

  • Fusion
  • Key words Complications
  • Minimally invasive
  • Spine
  • Spondylolisthesis
  • TLIF

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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