No abstract

Background Data: Degenerative lumbar spine, including spondylolisthesis, is a common clinical condition that affects humans in the most productive period of their life. There are many surgical options for the management of such conditions after the failure of conservative therapy. Recently, there has been a great debate regarding the use of minimally invasive (MI) versus open transforaminal lumbar interbody fusion (O-TLIF) in the treatment of single-level low-grade lumbar spondylolisthesis, so there was a need to reach a consensus over this issue. Purpose: To compare the clinical efficacy and safety of MI-TLIF versus O-TLIF in the treatment of single-level low-grade degenerative lumbar spondylolisthesis. Study Design: A systematic review for recent studies in the context and meta-analysis. Patients and Methods: We searched online databases of PubMed, Google Scholar, Cochrane Library, and DOAJ (2016-2020), and the search yielded 1352 articles. Based on our inclusion and exclusion criteria, we included retrospective, prospective, and randomized control trials, which came down to 11 research articles. Operative time, blood loss, hospital stay, back pain scores (Visual Analogue Scale), functional score (Oswestry Disability Index), complication rate, and reoperation rate for both techniques were recorded and presented as means. We then performed a meta-analysis. Results: There is an overall advantage for the MI-TLIF over the O-TLIF in different parameters. There was a statistically significant difference in blood loss of −0.954 ml (p = 0.000) and hospital stay of −1.19 days (P = 0.000), favoring M-TLIF. There was a statistically insignificant difference in the total operative time (P = 0.071), the postoperative VAS of −0.22 (P = 0.384), and the postoperative ODI of −2 (P = 0.331). Moreover, there was a reduced combined odds ratio for complications and a reduced odds ratio for re-operation.

Background Data: The supraorbital eyebrow approach is a minimally invasive keyhole technique that offers wide access to the anterior skull base and parasellar region using the subfrontal corridor, with assistances of neuroendoscopy The approach through the eyebrow permits access to a number of lesions in the subfrontal corridor with minimal brain retraction and a much smaller area of potential injury of main structures. Study Design: This study is a follow up study. Objective: To evaluate the role of supraorbital endoscopic approach for tumors of anterior and middle skull base. Patients and Methods: All the operations were performed at Suez Canal University hospitals, in about 24 months, the first 30 patients having tumors of anterior and middle skull base fulfilling the inclusion criteria were included in this prospective study. Results: Endoscopy can play an important role in improving visualization through the keyhole corridor. With the use of neuroendoscopy, the reach of this approach may be extended even further to include the pituitary fossa, the top third of the clivus, the interpeduncular cistern, the anterior third ventricle, and the medial and anterior temporal lobe and middle fossa.The major advantage of the supraorbital over the endonasal route is a simplified skull base closure and reduced risk of postoperative CSF leak. It is a valuable approach for selected patients. Neuromonitoring may further increase surgical safety. Conclusion: The approach through the eyebrow permits access to a number of lesions in the subfrontal corridor With the use of the assisstence of neuroendoscopy, with minimal brain retraction and a much smaller area of potential injury of anatomical structures.