286 - Low-grade Degenerative Spondylolisthesis Treated by Stand-alone Latera...

#286 Low-grade Degenerative Spondylolisthesis Treated by Stand-alone Lateral Interbody Fusion

MIS Techniques and Outcomes

Poster Presented by: L. Pimenta

Author(s):

L. Pimenta (1), (2)
R. Jensen (1)
L. Marchi (1)
L. Oliveira (1)
C. Castro (1)
E. Coutinho (1)
T. Coutinho (1)
R. Amaral (1)

(1) Instituto de Patologia da Coluna, Sao Paulo, Brazil
(2) UCSD, Neurosurgery, San Diego, CA, USA

Abstract

Purpose: Posterior approaches still bring risks muscle damage and postoperative morbidity. The optimal surgical treatment for lumbar spondylolisthesis remains unclear. The purpose of this paper was to investigate the stand-alone lateral interbody fusion as a minimally invasive for the treatment of low-grade degenerative spondylolisthesis.

Methods: Prospective non-randomized single-center study. Were included 52 patients (67.6 ± 10 y/o; 73.1% female; 27.4 ± 3.4 BMI) with single-level grade I or II degenerative spondylolisthesis without significant spine instability. Fusion procedures were performed as retroperitoneal lateral interbody fusions without screw supplementation. Clinical and radiological features were analyzed at the preop and postop periods with minimum 24-month follow-up.

Results: The procedures were performed without intraoperative complication (average 73.2 minutes and with less than 50cc blood loss). VAS and Oswestry scores testified lasting improvements in clinical outcomes. The mean value of vertebra slippage reduced in 90.4% of total cases from 15.1% to 7.4% at 6-week follow-up (p< 0.0001) and was maintained until 24 months (7.1%, p< 0.001). Significantly segmentar lordosis (p< 0.0001) and global lordosis (p< 0.01) improved at early evaluations but only segmentar lordosis lasted in the last follow-up (p< 0.0001). Disc height gain was also testified in all evaluations (p< 0.0001). Cage subsidence occurred in 17% of total cases and seven spine levels were needed revision surgery. At 24-month evaluation solid fusion was observed in 86.5% of total spine levels treated.

Conclusions: This minimal invasive technique has shown to be a safe and reproducible technique to treat low-grade degenerative spondylolisthesis, with satisfactory achievements on radiological parameters and clinical improvement.

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