Comparison Of The Effects Of MIS-TLIF And PLIF In The Treatment Of Lumbar Spondylolisthesis On Spine Pelvis Sagittal Plane Parameters

Objective:To investigate the effects of minimally invasive lumbar intervertebral fusion via intervertebral foramen(MIS-TLIF)and posterior lumbar intervertebral fusion(PLIF)on the spinal pelvic sagittal parameters in degenerative lumbar spondylolisthesis.Methods:The data of 60 patients with lumbar degenerative spondylolisthesis who underwent spinal surgery in our hospital from January 2019 to December2022 were retrospectively analyzed.There were 21 males and 39 females,aged(63 ± 7)years,average follow-up time 12 ± 3.6 months.Divide the patients into PLIF group and MIS-TLIF group according to the different surgical procedures.Compare the changes in imaging parameters of the spine and pelvis before and after the surgery,and compare the differences between the surgical time,intraoperative bleeding,VAS and ODI scores before and at the last follow-up.The correlation between quality of life scores,spinal and pelvic imaging parameters,and surgical methods in the two groups was analyzed and compared.Results:(1)Comparison of imaging parameters between the PLIF group and the last follow-up showed that there were statistically significant differences in five imaging indicators: lumbar lordosis angle(P=0.042),fusion segment angulation(P=0.022),slip angle(P<0.001),intervertebral space height(P<0.001),and pelvic incidence angle matching with lumbar lordosis angle(P=0.022).There were statistically significant differences between VAS and ODI(P<0.001)scores before surgery and the last follow-up.(2)In the MIS-TLIF group,there was a statistically significant difference in imaging parameters between preoperative and final follow-up,including slip angle(P<0.001)and intervertebral space height(P<0.001).There was a statistically significant difference in VAS and ODI(P<0.001)scores between preoperative and final follow-up There were statistically significant differences between the PLIF group and the MIS-TLIF group in surgical time,intraoperative bleeding,and slip reduction rate.Conclusion:PLIF and MIS-TLIF can effectively improve the clinical symptoms of patients with low degree lumbar spondylolisthesis,but there are significant differences in spine pelvic imaging parameters;Compared to MIS-TLIF,PLIF significantly increases the slip angle,fusion segment angulation,and lumbar lordosis angle,resulting in stronger spinal pelvic compatibility,which may be more beneficial for improving lumbar sagittal balance.For patients with large pelvic angle of incidence and sacral inclination,choosing open surgery is more beneficial for maintaining sagittal balance.