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European Spine Journal

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01-08-2013 | Original Article

Comparison of minimally invasive fusion and instrumentation versus open surgery for severe stenotic spondylolisthesis with high-grade facet joint osteoarthritis

Authors: Eleftherios Archavlis, Mario Carvi y Nievas

Published in: European Spine Journal | Issue 8/2013

Abstract

Purpose

The object of this study was to compare minimally invasive surgery (MIS) with open surgery in a severely affected subgroup of degenerative spondylolisthetic patients with severe stenosis (SDS) and high-grade facet osteoarthritis (FJO).

Methods

From January 2009 to February 2010, 49 patients with severe SDS and high-grade FJO were treated using either MIS or open TLIF. Intraoperative and diagnostic data, including perioperative complications and length of hospital stay (LOS), were collected, using retrospective chart review. Surgical short- and long-term outcomes were assessed according to the Oswestry disability index (ODI) and visual analog scale (VAS) for back and leg pain.

Results

Comparing MIS and open surgery, the MIS group had lesser blood loss, significantly lesser need for transfusion (p = 0.02), more rapid improvement of postoperative back pain in the first 6 weeks of follow-up and a shorter LOS. On the other hand, we experienced in the MIS group a longer operative time. The distribution on the postoperative ODI (p = 0.841), VAS leg (p = 0.943) and back pain (p = 0.735) scores after a mean follow-up of 2 years were similar. The overall proportion of complications showed no significant difference between the groups (29 % in the MIS group vs. 28 % in the open group, p = 0.999).

Conclusion

Minimally invasive surgery for severe SDS leads to adequate and safe decompression of lumbar stenosis and results in a faster recovery of symptoms and disability in the early postoperative period.

Dhall SS, Wang MY, Mummaneni PV (2008) Clinical and radiographic comparison of mini-open transforaminal lumbar interbody fusion with open transforaminal lumbar interbody fusion in 42 patients with long-term follow-up. J Neurosurg Spine 9(6):560–565PubMedCrossRef

Gelalis ID, Arnaoutoglou C, Christoforou G, Lykissas MG, Batsilas I, Xenakis T (2010) Prospective analysis of surgical outcomes in patients undergoing decompressive laminectomy and posterior instrumentation for degenerative lumbar spinal stenosis. Acta Orthop Traumatol Turc 44(3):235–240PubMedCrossRef

Holly LT, Schwender JD, Rouben DP, Foley KT (2006) Minimally invasive transforaminal lumbar interbody fusion: indications, technique, and complications. Neurosurg Focus 20(3):E6PubMedCrossRef

Hsieh PC, Koski TR, Sciubba DM, Moller DJ, O’Shaughnessy BA, Li KW, Gokaslan ZL, Ondra SL, Fessler RG, Liu JC (2008) Maximizing the potential of minimally invasive spine surgery in complex spinal disorders. Neurosurg Focus 25(2):E19PubMedCrossRef

Logroscino CA, Proietti L, Pola E, Scaramuzzo L, Tamburrelli FC (2011) A minimally invasive posterior lumbar interbody fusion for degenerative lumbar spine instabilities. Eur Spine J 20(Suppl 1):S41–S45PubMedCrossRef

Lowe TG, Tahernia AD, O’Brien MF, Smith DA (2002) Unilateral transforaminal posterior lumbar interbody fusion (TLIF): indications, technique, and 2-year results. J Spinal Disord Tech 15(1):31–38PubMedCrossRef

Mummaneni PV, Rodts GE Jr (2005) The mini-open transforaminal lumbar interbody fusion. Neurosurgery 57(4 Suppl):256–261PubMedCrossRef

Oppenheimer JH, De Castro I, McDonnell DE (2009) Minimally invasive spine technology and minimally invasive spine surgery: a historical review. Neurosurg Focus 27(3):E9PubMedCrossRef

Park P, Foley KT (2008) Minimally invasive transforaminal lumbar interbody fusion with reduction of spondylolisthesis: technique and outcomes after a minimum of 2 years’ follow-up. Neurosurg Focus 25(2):E16PubMedCrossRef

10.

Park Y, Ha JW, Lee YT, Oh HC, Yoo JH, Kim HB (2011) Surgical outcomes of minimally invasive transforaminal lumbar interbody fusion for the treatment of spondylolisthesis and degenerative segmental instability. Asian Spine J 5(4):228–236PubMedCrossRef

11.

Pathria M, Sartoris DJ, Resnick D (1987) Osteoarthritis of the facet joints: accuracy of oblique radiographic assessment. Radiology 164(1):227–230PubMed

12.

Peng CW, Yue WM, Poh SY, Yeo W, Tan SB (2009) Clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion. Spine 34(13):1385–1389PubMedCrossRef

13.

Potter BK, Freedman BA, Verwiebe EG, Hall JM, Polly DW Jr, Kuklo TR (2005) Transforaminal lumbar interbody fusion: clinical and radiographic results and complications in 100 consecutive patients. J Spinal Disord Tech 18:337–346PubMedCrossRef

14.

Quante M, Kesten H, Richter A, Halm H (2012) Transforaminal lumbar interbody fusion for the treatment of degenerative spondylolisthesis. Orthopade 41(2):153–162PubMedCrossRef

15.

Rosenberg WS, Mummaneni PV (2001) TLIF: technique, complications, and early results. Neurosurgery 48:569–574PubMedCrossRef

16.

Ryang YM, Oertel MF, Mayfrank L, Gilsbach JM, Rohde V (2008) Standard open microdiscectomy versus minimal access trocar microdiscectomy: results of a prospective randomized study. Neurosurgery 62(1):174–181PubMedCrossRef

17.

Salehi SA, Tawk R, Ganju A, LaMarca F, Liu JC, Ondra SL (2004) Transforaminal lumbar interbody fusion: surgical technique and results in 24 patients. Neurosurgery 54:368–374PubMedCrossRef

18.

Scheufler KM, Dohmen H, Vougioukas VI (2007) Percutaneous transforaminal lumbar interbody fusion for the treatment of degenerative lumbar instability. Neurosurgery 60(4 Suppl 2):203–212PubMed

19.

Schizas C, Michel J, Kosmopoulos V, Theumann N (2007) Computer tomography assessment of pedicle screw insertion in percutaneous posterior transpedicular stabilization. EurSpine J 16(5):613–617

20.

Schizas C, Theumann N, Burn A, Tansey R, Wardlaw D, Smith FW, Kulik G (2010) Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images. Spine (Phila Pa 1976) 35(21):1919–1924CrossRef

21.

Schwender JD, Holly LT, Rouben DP, Foley KT (2005) Minimally invasive transforaminal lumbar interbody fusion (TLIF): technical feasibility and initial results. J Spinal Disord Tech 18(Suppl):S1–S6PubMedCrossRef

22.

Scott J, Huskisson EC (1976) Graphic representation of pain. Pain 2(2):175–184PubMedCrossRef

23.

Wang J, Zhou Y, Zhang ZF, Li CQ, Zheng WJ, Liu J (2010) Comparison of one-level minimally invasive and open transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2. Eur Spine J 19(10):1780–1784PubMedCrossRef

24.

Wang MY, Cummock MD, Yu Y, Trivedi RA (2010) An analysis of the differences in the acute hospitalization charges following minimally invasive versus open posterior lumbar interbody fusion. J Neurosurg Spine 12(6):694–699PubMedCrossRef

25.

Weiner BK, Nguyen HV, Hazard SW (2006) Transforaminal lumbar interbody fusion: an independent assessment of outcomes in a difficult patient population. Med Sci Monit 12:CR99–CR102PubMed

26.

Weinstein JN, Lurie JD, Tosteson TD, Zhao W, Blood EA, Tosteson AN, Birkmeyer N, Herkowitz H, Longley M, Lenke L, Emery S, Hu SS (2009) Surgical compared with non operative treatment for lumbar degenerative spondylolisthesis. Four-year results in the Spine Patient Outcomes Research Trial (SPORT) randomized and observational cohorts. J Bone Joint Surg Am 91(6):1295–1304PubMedCrossRef

27.

Whitecloud TS 3rd, Davis JM, Olive PM (1994) Operative treatment of the degenerated segment adjacent to a lumbar fusion. Spine (Phila Pa 1976) 19(5):531–536CrossRef

28.

Whitecloud TS 3rd, Roesch WW, Ricciardi JE (2001) Transforaminal interbody fusion versus anterior-posterior interbody fusion of the lumbar spine: a financial analysis. J Spinal Disord 14(2):100–103PubMedCrossRef

29.

Wood MJ, Mannion RJ (2010) Improving accuracy and reducing radiation exposure in minimally invasive lumbar interbody fusion. J Neurosurg Spine 12(5):533–539PubMedCrossRef

Title: Comparison of minimally invasive fusion and instrumentation versus open surgery for severe stenotic spondylolisthesis with high-grade facet joint osteoarthritis
Authors: Eleftherios Archavlis
Mario Carvi y Nievas
Publication date: 01-08-2013
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 8/2013
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-013-2732-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of minimally invasive fusion and instrumentation versus open surgery for severe stenotic spondylolisthesis with high-grade facet joint osteoarthritis

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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