Clinical Outcomes Of Minimally Invasive Transforaminal Iumbarinterbody Fusion For Low-grade Spondylolisthesis Via MAST Quadrant System

ObjectiveLumbar spondylolisthesisis a common degenerative spine disease, and it was divided into two types of isthmic spondylolisthesis and Degenerative spondylolisthesis. If the spondylolisthesisis progressive increase and the severe symptoms affected the lives and work of patients, it require surgery.The goal of surgery is to relieve nerve compression and reconstruct stability of the lumbar spine. Traditional lumbar spine surgery programs include posterolateral lumbar fusion(PLF), anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion(PLIF) and transforminal lumbar interbody fusoin(TLIF). Although these surgical methods have the advantage of thorough decompression, there is inadequate of large damage and other defects. With the rapid development of the concepts and devices of minimally invasive surgery, minimally invasive transforminal lumbar interbody fusoin(MI-TLIF) was widely used in the clinical. MI-TLIF through Wiltse approach iva MAST Quadrant system demonstrated significant reductions of operative time, length of stay, estimated blood loss and anesthesia time, compared with the open technique.The objective of this study was to explore the MI-TLIF techniques and clinical outcomes of lumbar spondylolisthesis with MI-TLIF via MAST Quadrant system.MethodsFifty-three patients with lumbar spondylolisthes who was undergoing MI-TLIF and open TLIF at our department from March2010to May2013were analyzed retrospectively(26MIS,27open).Patients in either cohort were matced based on race, sex and age. The clinical outcomes of Japanese Orthopaedic Association Scores(JOA), visual analog scale(VAS), the MOS item short form health survey (SF-36), operative time, length of stay, estimated blood loss, anesthesia time and such radiographic paramenters as preoperative and postoperative Tailard index, intervertebral height were evaluated. The MI-TLIF and open TLIF groups were compared based on clinical outcomes measures using SPSS version16.0for statistical analysis.ResultsAverage surgical time was shorter for open TLIF than the MI-TLIF group. Estimated blood loss, length of stay and frequency of painkiller were reduced for the MI-TLIF versus the open group (P<0.05). VAS and JOA scores decreased, and SF-36scores were rised, for both groups. And the fusion and complications rate were simillar in the two groups(P>0.05). ConclusionThis prospectively study shows statistically sinificant clinical outcomes improvement after open and MI-TLIF with low-grade spondylolisthesis. MI-TLIF resulted a high rate of spinal fusion and adjacent segment disease while reducing postoperative complications. MI-TLIF has the advantages of less invasion and quick recovery,but the long-term effectiveness needs more observation.