Direct Pars Defect Tubular Decompression and TLIF for the Treatment of Low-Grade Adult Isthmic Spondylolisthesis: Surgical Challenges and Nuances of a Muscle-Sparing Minimally Invasive Approach

Roberti, Fabio; Arsenault, Katie

doi:10.1155/2020/5346805

Cited by 1 publication

(1 citation statement)

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“…At present, there are several known modifications of mini-invasive methods of treating spondylolisthesis including those with segment fixation which are used in the surgery of isthmic spondylolysis with spondylolisthesis in adults. These methods include segment fixation with transforaminal lumbar interbody spondylodesis with direct muscle-sparing decompensation of a part of the defect [ 20 , 21 ]. The mini-invasive technique employed in this study consists in consolidation of the interarticular part of the vertebral arch with stabilization of the spinal motion segment using its own articular process.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Reconstruction of Vertebral Arch in Spondylolisthesis in Children and Adolescents

Syundyukov¹,

Nikolayev²,

Kuz'mina³

et al. 2021

Sovrem Tehnol Med

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The aim of the study was to assess the effectiveness of the minimally invasive technique used to reconstruct the vertebral arch with a pedicle screw hook system in grade I isthmic spondylolisthesis in comparison with the traditional technique of segment stabilization with interbody fusion. Materials and Methods The study included 26 patients aged from 11 to 17 years. The follow-up period lasted from 1 to 7 years. Two groups were formed: in group 1 (n=6), segments L 5 –S 1 were stabilized using the traditional technique; in group 2 (n=20), the arch of the L 5 vertebra was reconstructed by means of minimally invasive surgery. The pain syndrome was assessed in each study group using the visual analogue scale and Macnab criteria before and after surgery; blood loss, duration of surgery in minutes, and hospitalization in days were also measured. Results According to the Macnab scale, the two presented techniques did not show any statistically significant differences; however, when the arch synthesis technique was employed the spinal motion segment remained intact. Furthermore, in group 2, the volume of blood loss was smaller (44.0±19.6 compared to 300.0±130.4 ml, p<0.0001), the duration of the operation was 176.0±41.6 compared to 349.2±93.2 min, p<0.0001, and hospital stay was 6.9±1.6 compared to 10.0±2.1 days, p=0.0025 in the control group. Conclusion The technique of vertebral arch reconstruction by a minimally invasive access gives the possibility to stabilize the spinal motion segment and to preserve biomechanics and movements in the spine. This technique allows for shorter inpatient stays for patients as well as earlier recovery and rehabilitation due to reduced surgery time and blood loss.

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Section: Discussionmentioning

confidence: 99%