Minimally Invasive Versus Open TLIF in the Management of Lumbar Spondylolisthesis

Abstract

This study aims to assess the difference between minimal invasive TLIF surgery and conventional TLIF surgery in cases of lytic spondylolisthesis, as regards pain, disability, hospital stay and complications. Lytic Spondylolisthesis patients may require fusion of one or more spinal segments to treat their condition adequately. The chances of achieving a successful lumbar spinal fusion has increased. TLIF technique is gradually being accepted in these cases and widely used by most spine surgeons. Minimal invasive TLIF is a recent trend for spinal fusion. This is a prospective randomized comparative study conducted from March 2016 to December 2018 included forty patients with low grade lytic spondylolisthesis that underwent surgeries. Twenty patients underwent MI-TLIF through percutaneous posterior lumbar pedicular screw fixation, microscopic minimally invasive transformational discectomy and interbody cage fusion (patients group "A") and another twenty patients underwent traditional open posterior lumbar pedicular screw fixation and TLIF (control group "B"). In our results, both surgical techniques showed improvement in pain and function within 12 months (follow up period), but group A showed statistically significant improvement in pain and function in the 1 st three months. Regarding blood loss, need for transfusion and hospital stay, group A showed statistically significant better results. As a conclusion, minimally invasive TLIF is a better option in surgical management of spondylolisthesis especially in the early postoperative period.