Journal List > J Korean Soc Spine Surg > v.24(2) > 1076163

J Korean Soc Spine Surg. 2017 Jun;24(2):95-102. Korean.
Published online June 30, 2017.  https://doi.org/10.4184/jkss.2017.24.2.95
© Copyright 2017 Korean Society of Spine Surgery
Can Unilateral Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS TLIF) Result in Sufficient Reduction in Spondylolisthesis?: A Comparison with Open TLIF and Bilateral MIS TLIF
Ki-Hyoung Koo, M.D., Ph.D., Jangyun Lee, M.D. and Jae-Hyun Kim, M.D.
Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.

Corresponding author: Ki-Hyoung Koo, M.D., Ph.D. Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, 27 Dongguk-ro, Ilsandong-gu, Goyang-city, Gyeonggi, 10326, Korea. TEL: +82-31-961-7294, FAX: +82-31-961-7290, Email: drkookh@gmail.com
Received April 07, 2017; Revised April 10, 2017; Accepted June 01, 2017.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Study Design

Retrospective study.

Objectives

To compare the radiologic results of unilateral or bilateral minimal invasive transforaminal lumbar interbody fusion (MIS TLIF) and conventional open lumbar interbody fusion.

Summary of Literature Review

Only a few studies have compared the slip reduction and fusion rate between unilateral or bilateral MIS TLIF and conventional open TLIF.

Materials and Methods

Between March 2007 and May 2015, 80 patients with single-level low-grade spondylolisthesis underwent unilateral MIS TLIF (26 patients), bilateral MIS TLIF (10 patients), or open TLIF (44 patients) by a single surgeon. Radiologic studies were performed preoperatively, 2 weeks postoperatively, and 12 months postoperatively. Slip reduction, the lumbar lordortic angle, and the fusion rate were analyzed.

Results

The 3 groups exhibited significantly improved slip after operation. Significant differences were found among the 3 groups (p=0.015) and between the MIS TLIF group (31.76%±14.42%) and the open TLIF group (41.66%±15.98%) (p=0.01) in the slip reduction rate at 2 weeks after the operation. However, no significant difference was found between unilateral MIS TLIF and bilateral MIS TLIF (37.61%±15.0% vs. 29.5%±13.82%, p=0.148). In the lumbar lordotic angle, no significant difference was found among the 3 groups. There were no significant differences among the 3 groups in slip reduction or the fusion rate at 12 months after the operation.

Conclusions

Our study suggests that unilateral MIS TLIF showed a similar slip reduction and fusion rate to bilateral MIS TLIF, but that conventional open TLIF showed better slip reduction than MIS TLIF, although it had a similar fusion rate.

Keywords: Lumbar spine; Spondylolisthesis; Minimally invasive transforaminal lumbar interbody fusion; Slip reduction; Fusion rate

Figures


Fig. 1
Slip measurement.
Slip percentage is expressed as the percentage of the anterior-posterior diameter of the top of the lower vertebra. On a lateral radiograph, a line is drawn along the posterior border of the lower vertebral body and another line perpendicular to this is drawn at the superior part of the lower vertebra. A third line is drawn along the posterior border of the upper vertebral body. The anterior translation or displacement of the upper vertebral body as a proportion of the width of the lower vertebral body is expressed as a percentage. (A) Preoperative lateral standing X-ray and (B) postoperative lateral standing X-ray.
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Tables


Table 2
Preoperative and postoperative radiological results (slip reduction)
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Table 3
Preoperative and postoperative radiological results (lumbar lordosis and fusion rate)
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