EFFECTIVENESS IN INDIRECT DECOMPRESSION USING MINIMALLY INVASIVE SURGERY - TRANSFORAMINAL LUMBAR INTERBODY FUSION IN...

Area of Science:

• Spine surgery
• Minimally invasive spinal techniques
• Degenerative spine conditions

Background:

• Lateral indirect decompression is advantageous for low-grade spondylolisthesis and mild canal stenosis compared to posterior approaches.
• Minimally invasive surgery transforaminal lumbar interbody fusion (MIS TLIF) allows nerve release without direct exposure, enhanced by intraoperative neuromonitoring for safety.

Purpose of the Study:

• To evaluate the safety and efficacy of MIS TLIF for indirect decompression in single-level lumbosacral spondylolisthesis.
• To assess clinical and radiographic outcomes, including pain, function, and complications.

Main Methods:

• A prospective study of 20 patients with single-level lumbosacral spondylolisthesis undergoing MIS TLIF from 2022 to March 2024.
• Superior-articular process removal for Kambin's triangle enlargement without nerve structure exposure, guided by intraoperative neuromonitoring.
• Data collection included pre- and post-operative VAS, ODI, MacNab criteria, and radiographic parameters.

Main Results:

• Significant improvements in VAS back pain (7.4 to 0.8) and leg pain (7.1 to 0.9), and ODI (52.4% to 15.6%).
• High rate of spondylolisthesis correction (85%), improved disc height (+6 mm), foraminal height (+3.1 mm), and segmental lordosis (+4.8°).
• Excellent outcomes (75% excellent, 20% good) by modified MacNab criteria with no reported complications.

Conclusions:

• Indirect decompression via MIS TLIF is a safe and effective technique for managing single-level lumbosacral spondylolisthesis.
• The procedure demonstrates favorable clinical and radiographic outcomes, supporting its use in spine surgery.