• World Neurosurg · Feb 2022

    Comparison of Minimally Invasive LLIF, Minimally Invasive TLIF, and Open PLIF in the Treatment of Single-Level Spondylolisthesis of L4-L5.

    • Hae-Dong Jang, Jae Chul Lee, Jong-Hyeon Seo, Young-Ho Roh, Sung-Woo Choi, and Byung-Joon Shin.
    • Department of Orthopaedic Surgery, Soonchunhyang University Bucheon Hospital, Gyeonggi-do, Republic of Korea.
    • World Neurosurg. 2022 Feb 1; 158: e10-e18.

    ObjectiveTo compare the outcomes of minimally invasive lateral lumbar interbody fusion (LLIF) with minimally invasive transforaminal lumbar interbody fusion (TLIF) and conventional open posterior lumbar interbody fusion (PLIF) for treating single-level spondylolisthesis at L4-L5.MethodsThe patients underwent minimally invasive LLIF (n = 18), minimally invasive TLIF (n = 17), and conventional open PLIF (n = 20) for spondylolisthesis at L4-L5. Reduction of slippage, improvement in segmental lordosis, and restoration of foraminal height were measured. Perioperative parameters such as blood loss and operation time and clinical outcomes such as visual analog scale score and Oswestry Disability Index were compared.ResultsCompared with the open PLIF group, the minimally invasive LLIF group showed greater restoration of mean foraminal height, significantly smaller mean intraoperative estimated blood loss, and less mean hemoglobin reduction on the third day postoperatively. Compared with the minimally invasive TLIF group, the minimally invasive LLIF group showed greater restoration of mean segmental lordosis. The minimally invasive LLIF group showed a significantly shorter mean time to start walking after surgery compared with the conventional open PLIF and minimally invasive TLIF groups. However, compared with the minimally invasive TLIF group, the minimally invasive LLIF group showed a significantly longer mean operating time. Clinical outcomes were not statistically different among the 3 groups.ConclusionsIn the treatment of spondylolisthesis of L4-L5, minimally invasive LLIF provided an effective surgical alternative to minimally invasive TLIF or conventional open PLIF, with the advantages of less blood loss, the faster start of postoperative walking, and comparable improvement in radiologic parameters.Copyright © 2021 Elsevier Inc. All rights reserved.

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