One-Level Lumbar Degenerative Spondylolisthesis and Posterior Approach: Is Transforaminal Lateral Interbody Fusion Mandatory?

Challier, Vincent; Boissière, Louis; Obeid, Ibrahim; Vital, Jean-Marc; Castelain, Jean-Etienne; Bénard, Antoine; Ong, Nathalie; Ghailane, Soufiane; Pointillart, Vincent; Mazas, Simon; Mariey, R; Gille, Olivier

doi:10.1097/brs.0000000000001857

Cited by 66 publications

(51 citation statements)

References 60 publications

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“…A better understanding of the complications rate of and risk factors for unplanned reoperations may help improve surgical outcomes and prognoses. It was reported that the cumulative reoperation rate in lumbar degenerative diseases was 4.7% at 3 months, 6.1% at 1 year, 8.5% at 2 years, 15.2% at 3 years, 17.7% at 5 years and 23.3% (38/163 patients) at the final follow-up [ 4 – 8 ]. Reducing the rate of lumbar surgery revision is also vital because the outcomes of DLS reoperation may be worse than the results of the initial surgical management.…”

Section: Introductionmentioning

confidence: 99%

Complications rate of and risk factors for the unplanned reoperation of degenerative lumbar spondylolisthesis in elderly patients: a retrospective single-Centre cohort study of 33 patients

et al. 2020

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Background: The study was to investigate the complications rate of and risk factors for unplanned reoperation among elderly patients who underwent posterior lumbar fusion (PLF) for degenerative lumbar spondylolisthesis (DLS). Methods: A total of 1100 DLS patients who were older than 60 years were reviewed from January 2006 to December 2016. 33 patients underwent unplanned reoperations and were analysed and divided into two groups (group A: posterolateral fusion, 650 patients; group B: intervertebral fusion, 450 patients). Sex, body mass index (BMI), radiographic data and clinical outcome data were analysed to evaluate the complications rate of and the risk factors for unplanned reoperations. Results: A total of 33 patients underwent unplanned reoperations (3%). The patients were followed up for an average of 4.20 ± 2.25 years (group A) and 4.32 ± 2.54 years (group B) without a significant difference. Significant differences were found in mean age, levels of involvement, hospital stay, surgery time, and blood loss between the groups. The causes of unplanned operation were wound infection, screw misplacement, neurological deficit, nonunion, and screw fracture, which were significant except for wound infection between the groups. Higher BMI (obesity), diabetes mellitus (DM), more bleeding and sex (female) were risk factors for complications. Cases of screw misplacement, neurological deficit, nonunion and screw fracture in group A were more significant than those in group B. Conclusion: Patients with higher BMI, DM, older age, posterolateral fusion, and female sex predicted a higher incidence of unplanned reoperations. Spine surgeons may need to pay more attention to their preoperative training and to improving surgical techniques that could reduce the reoperation rate.

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Section: Introductionmentioning

confidence: 99%

Complications rate of and risk factors for the unplanned reoperation of degenerative lumbar spondylolisthesis in elderly patients: a retrospective single-Centre cohort study of 33 patients

et al. 2020

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“…Endler et al, [18] , in their prospective study reported a 51.25% improvement in ODI score in PLF group. Challier et al, [19] in their RCT, reported that ODI scores improved by 19 in the PLF group. Etemadifar et al, [20] in their RCT, observed that ODI improved by 53.2% in the PLF group.…”

Section: Discussionmentioning

confidence: 93%

“…We had a significant improvement in clinical outcome and we analyzed if the radiological outcome in terms of fusion supported it. Challier et al's RCT [19] reported a fusion rate of 56.7% in the PLF group. Lee et al's study [21] showed a fusion rate of 89.7% at 2 year follow up in PLF group Levin et al, 2018 [22] , in their meta-analysis of 2 RCT's and 5 cohort studies, reported that the pooled fusion success rate was 84.7% in the PLF group of patients.…”

Section: Discussionmentioning

confidence: 97%

“…Endler et al, 2017 [18] , in a prospective study reported that the VAS scores for back pain reduced by 63% and for radiating pain reduced by 55% in patients who underwent PLF at two years follow up. Challier et al, 2017 [19] , in a randomized controlled trial (RCT) reported that VAS back pain improved by 3.8 and VAS leg pain improved by 3.4 in the PLF group. Etemadifar et al, 2016 [20] in a RCT with two years follow up reported that the VAS scores for back pain and leg pain were significantly decreased in PLF group.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of instrumented posterolateral fusion in patients with low grade lumbar spondylolisthesis

Nimmagadda¹,

Seenappa²,

Mittemari³

2020

Int. J. Orthop. Sci.

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Background: Spondylolisthesis the forward slippage of a cephalad vertebra on a caudal vertebra. Fusion is the recommended procedure for spondylolisthesis. However, choice between the different methods of fusion remains under debate. Posterolateral fusion with posterior instrumentation (PLF) has shown good clinical outcomes and fusion rates. Objectives: To study clinical and radiological outcomes of PLF in grade 1 and 2 spondylolisthesis. Methods: This is a prospective study of 30 patients who underwent PLF and followed up for 2 years. The outcome measures were (1) clinical outcomes as assessed with a visual analogue scale and the Modified Oswestry Disability Index, (2) the fusion rate based on radiographs. Results: There was a significant improvement in VAS of low back pain (82.45%, p< 0.001) and VAS of radiating (93.55%; p< 0.001). The ODI scores were significantly improved (69.86%, p< 0.001) at 2 years follow up. The fusion rate was 70% and 63.33% patients reported excellent outcomes. Conclusion:Based on 2 year clinical outcomes and the fusion rates of PLF, we conclude that PLF is an excellent surgical procedure for management of low grade spondylolisthesis.

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“…81 A systematic review and meta-analysis by Levin et al comparing PLF with transforaminal lumbar interbody fusion (TLIF) from five observational studies, also favoured TLIF for achieving improvement in ODI and back pain and better fusion rates. 82 However, these findings have been challenged by a recent RCT with two-year follow-up, which has found no additional benefit of TLIF over PLF with regard to clinical or radiographic alignment parameters despite a better fusion rate, 83 with similar findings reported in a retrospective cohort study by Fujimori et al 84 Furthermore, a systematic review and meta-analysis by McAnany et al, comparing the effectiveness of PLF and interbody fusion from five observational studies, has found no difference in clinical outcome (ODI, Short Form-36 [SF-36], VAS score), fusion rates or complication rates. 85…”

Section: Operative Managementmentioning

confidence: 99%

Management of symptomatic degenerative low-grade lumbar spondylolisthesis

Evans

McCarthy

2018

EFORT Open Reviews

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Degenerative low-grade lumbar spondylolisthesis is the most common form of spondylolisthesis.The majority of patients are asymptomatic and do not require surgical intervention.Symptomatic patients present with a combination of lower back pain, radiculopathy and/or neurogenic claudication and may warrant surgery if non-operative measures fail.There is widespread controversy regarding the indications for surgery and appropriate treatment strategies for patients with this type of spondylolisthesis.This article provides a comprehensive evidence-based review of the available literature to support the management of degenerative low-grade spondylolisthesis.Cite this article: EFORT Open Rev 2018;3:620-631. DOI: 10.1302/2058-5241.3.180020.

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One-Level Lumbar Degenerative Spondylolisthesis and Posterior Approach: Is Transforaminal Lateral Interbody Fusion Mandatory?

Abstract: 2.

Cited by 66 publications

References 60 publications

Complications rate of and risk factors for the unplanned reoperation of degenerative lumbar spondylolisthesis in elderly patients: a retrospective single-Centre cohort study of 33 patients

Complications rate of and risk factors for the unplanned reoperation of degenerative lumbar spondylolisthesis in elderly patients: a retrospective single-Centre cohort study of 33 patients

Outcomes of instrumented posterolateral fusion in patients with low grade lumbar spondylolisthesis

Management of symptomatic degenerative low-grade lumbar spondylolisthesis

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