Simultaneous Single-Position Lateral Lumbar Interbody Fusion Surgery and Unilateral Percutaneous Pedicle Screw Fixation for Spondylolisthesis

Hui Lv; Yu Sheng Yang; Jian Hong Zhou; Yuan Guo; Hui Chen; Fei Luo; Jian Zhong Xu; Zhong Rong Zhang; Ze Hua Zhang

doi:10.14245/ns.2346378.189

Simultaneous Single-Position Lateral Lumbar Interbody Fusion Surgery and Unilateral Percutaneous Pedicle Screw Fixation for Spondylolisthesis

Neurospine. 2023 Sep;20(3):824-834. doi: 10.14245/ns.2346378.189. Epub 2023 Sep 30.

Authors

Hui Lv^{1

2}, Yu Sheng Yang², Jian Hong Zhou^{1

2}, Yuan Guo², Hui Chen^{1

2}, Fei Luo^{1

2}, Jian Zhong Xu^{1

2}, Zhong Rong Zhang^{1

2}, Ze Hua Zhang^{1

2}

Affiliations

¹ Department of Orthopaedic, Southwest Hospital, The First Affiliated Hospital of Army Medical University, Chongqing, China.
² Department of Orthopaedic, Jiangbei Branch of Southwest Hospital, Chongqing, China.

Abstract

Objective: To evaluate the clinical and radiological efficacy of a combine of lateral single screw-rod and unilateral percutaneous pedicle screw fixation (LSUP) for lateral lumbar interbody fusion (LLIF) in the treatment of spondylolisthesis.

Methods: Sixty-two consecutive patients with lumbar spondylolisthesis who underwent minimally invasive (MIS)-TLIF with bilateral pedicle screw (BPS) or LLIF-LSUP were retrospectively studied. Segmental lordosis angle (SLA), lumbar lordosis angle (LLA), disc height (DH), slipping percentage, the cross-sectional areas (CSA) of the thecal sac, screw placement accuracy, fusion rate and foraminal height (FH) were used to evaluate radiographic changes postoperatively. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the clinical efficacy.

Results: Patients who underwent LLIF-LSUP showed shorter operating time, less length of hospital stay and lower blood loss than MIS-TLIF. No statistical difference was found between the 2 groups in screw placement accuracy, overall complications, VAS, and ODI. Compared with MIS-TLIF-BPS, LLIF-LSUP had a significant improvement in sagittal parameters including DH, FH, LLA, and SLA. The CSA of MIS-TLIF-BPS was significantly increased than that of LLIF-LSUP. The fusion rate of LLIF-LSUP was significantly higher than that of MIS-TLIF-BPS at the follow-up of 3 months postoperatively, but there was no statistical difference between the 2 groups at the follow-up of 6 months, 9 months, and 12 months.

Conclusion: The overall clinical outcomes and complications of LLIF-LSUP were comparable to that of MIS-TLIF-BPS in this series. Compared with MIS-TLIF-BPS, LLIF-LSUP for lumbar spondylolisthesis represents a significantly shorter operating time, hospital stay and lower blood loss, and demonstrates better radiological outcomes to maintain lumbar lordosis, and reveal an overwhelming superiority in the early fusion rate.

Keywords: Minimally invasive surgical procedures; Pedicle screws; Single-position; Spinal fusion; Spondylolisthesis.

Abstract

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