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Abstract
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.
REFERENCES
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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.
Table 1.
Demographic data
Table 2.
Preoperative and postoperative radiological results (slip reduction)
| Open TLIF∗ | Unilateral MIS TLIF† | Bilateral MIS TLIF | P-value | |
|---|---|---|---|---|
| Preoperative slip | 18.45±6.22 | 17.71±4.14 | 15.95±4.86 | p=0.209 |
| Postoperative slip | 10.78±4.67 | 12.40±3.33 | 9.71±3.05 | |
| Reduction rate | 41.66±15.98 | 29.51±13.82 | 37.61±15.01 | p=0.015 |
| Reduction rate (1 y) | 31.83±17.38 | 20.82±11.68 | 29.32±13.28 | p=0.022 |
| Reduction loss (1 y) | 25.21±20.86 | 31.27±16.17 | 24.69±20.22 | p=0.117 |
Table 3.
Preoperative and postoperative radiological results (lumbar lordosis and fusion rate)
| Open TLIF∗ | Unilateral MIS TLIF† | Bilateral MIS TLIF | P-value | |
|---|---|---|---|---|
| Lumbar lordosis (pre) | 45.1±11.25 | 45.96±11.38 | 39.31±9.23 | p=0.623 |
| Lumbar lordosis (2 weeks) | 47.95±11.20 | 48.06±11.94 | 43.55±9.09 | |
| Lumbar lordosis (1 y) | 49.14±11.45 | 47.81±12.72 | 43.9±11.62 | p=0.412 |
| Fusion rate (%) | 86.36 | 69.23 | 80 | p=0.087 |
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