Minimally Invasive Lumbar Decompression Versus Minimally Invasive Transforaminal Lumbar Interbody Fusion for Treatment of Low-Grade Lumbar Degenerative Spondylolisthesis

STUDY DESIGNA retrospective cohort comparison study. OBJECTIVETo compare perioperative outcomes, radiographic parameters, and patient-reported outcome measures (PROMs) between minimally invasive unilateral laminotomy with bilateral decompression (MIS-ULBD) versus MIS transforaminal lumbar interbody...

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Published in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 2022-11, Vol.47 (21), p.1505-1514
Main Authors: Bovonratwet, Patawut, Samuel, Andre M., Mok, Jung Kee, Vaishnav, Avani S., Morse, Kyle W., Song, Junho, Steinhaus, Michael E., Jordan, Yusef J., Gang, Catherine H., Qureshi, Sheeraz A.
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Language:English
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Summary:STUDY DESIGNA retrospective cohort comparison study. OBJECTIVETo compare perioperative outcomes, radiographic parameters, and patient-reported outcome measures (PROMs) between minimally invasive unilateral laminotomy with bilateral decompression (MIS-ULBD) versus MIS transforaminal lumbar interbody fusion (MIS-TLIF) for treatment of low-grade lumbar degenerative spondylolisthesis. SUMMARY OF BACKGROUND DATAWhile lumbar degenerative spondylolisthesis is a common condition, optimal surgical treatment remains controversial. Newer MIS techniques, which preserve bone, paraspinal musculature, and posterior midline stabilizers, are thought to reduce the risk of iatrogenic instability and may obviate the need for fusion. However, few comparative studies of MIS techniques for low-grade lumbar degenerative spondylolisthesis currently exist. MATERIALS AND METHODSConsecutive patients with low-grade (Meyerding grade I or II) lumbar degenerative spondylolisthesis treated with single-level MIS-ULBD or MIS-TLIF were identified retrospectively from a prospectively collected spine surgery registry from April 2017 to November 2021. Perioperative outcomes, radiographic data, and PROMs were assessed. RESULTSA total of 188 patients underwent either MIS-ULBD or MIS-TLIF (79 MIS-ULBD and 109 MIS-TLIF). Patients who underwent MIS-ULBD tended to be older, had higher Charlson Comorbidity Index, lower mean percentage back pain, higher percentage of L4/L5 pathology, shorter operative time, lower estimated blood loss, and lower postoperative pain ( P
ISSN:0362-2436
1528-1159
DOI:10.1097/BRS.0000000000004432