Intraoperative reduction does not result in better outcomes in low-grade lumbar spondylolisthesis with XXXX after minimally invasive transforaminal lumbar interbody fusion-a 5-year follow-up study.

@entity1 @entity190 @entity1109 @entity158 @entity717 @entity528
BACKGROUND CONTEXT: Intraoperative reduction of low-grade lumbar spondylolisthesis (LGLS) remains disputed. There is currently no published data comparing midterm outcomes of reduction versus in situ fusion. PURPOSE: This study aimed to compare mid-term clinical, radiological, and perioperative outcomes for reduction versus in situ fusion in LGLS with @entity1109 . STUDY DESIGN/SETTING: A retrospective review of prospectively collected spine registry data in a single institution was carried out. @entity1 SAMPLE: All @entity1 who underwent minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) for LGLS with @entity1109 with a minimum 5-year follow-up comprised the @entity1 sample. OUTCOME MEASURES: Self-reported measures were @entity717 Index, North American Spine Society Neurogenic Symptom Score, Health Outcomes Survey Short Form-36 score, and Numerical Pain Rating Scale (back and leg @entity158 ). Radiological outcomes were fusion grading, @entity528 ( @entity528 ), and implant failure or loosening. Perioperative outcomes were fluoroscopic time, operative time, intraoperative @entity190 , opioid analgesia usage, time to ambulation, duration of hospitalization, and complication rate. Functional outcomes were @entity1 satisfaction rate and rate of return to full function. METHODS: A retrospective review was performed on prospectively collected registry data of @entity1 undergoing MIS TLIF for LGLS with @entity1109 , from 2004 to 2009. The operative technique and postoperative protocol were standardized. Two groups were formed based on complete reduction of the spondylolisthesis (reduction group [RG]) or the lack thereof (non-reduction group [NRG]) in the immediate postoperative radiograph. Outcomes at baseline, 6 months, 2 years, and 5 years postsurgery were compared. RESULTS: There were 56 @entity1 included (RG=30, NRG=26). The two groups had comparable baseline characteristics: demographics, body mass index, spondylolisthesis etiology, spinal level involved, bone graft and bone morphogenetic protein used, and all self-reported outcome measures. Perioperative outcomes were not significantly different. The early complication rate (RG=3.3%, NRG=19.2%, p=.086) and late complication rate (RG=10%, NRG=23.1%, p=.184) were similar. All @entity1 achieved Bridwell grade 1 fusion from 2 years onward. @entity528 rate at 5 years was similar (RG=10%, NRG=0%, p=NS). Both groups showed significant postoperative improvement in all self-reported measures with no significant differences between the two groups at all follow-up points. Functional outcomes were equivalent. CONCLUSIONS: Intraoperative reduction does not improve outcomes in LGLS with @entity1109 after MIS TLIF. Adequate decompression and solid fusion are likely the keys to good mid-term outcomes.
