Minimally invasive surgery procedure in isthmic spondylolisthesis.
PURPOSE
The aim of the study was to evaluate the efficacy and safety of the direct lateral approach to the lumbar spine in the treatment of painful isthmic spondylolisthesis in adults.


METHODS
Twenty-one patients affected by isthmic spondylolisthesis and treated with extreme lateral interbody fusion and posterior percutaneous pedicle screw fixation were enrolled. All included patients were clinically evaluated with Oswestry Disability Index, SF36 and Visual Scale Anatomy (VAS) for back pain at 1, 3 months and at 1 year.


RESULTS
The mean correction of vertebral slippage measured on lateral lumbar X-ray was 56.3% (p = 0.002). The average preoperative VAS score was 7.1, at 1 year decreasing to 2.2 (p = 0.001). The patients had an average preoperative "Oswestry Disability Index" of 36.8 and 24.1% after 1 year (p = 0.02). The preoperative Short-Form 36 Physical Health was equal to 33.8, 72.1% after 1 month, to 76.3% after 3 months and to 83.2% (p = 0.001) after 1 year of follow-up. There were no signs of implant loosening at 1-year CT scan examination in any of the patients.


CONCLUSION
The study showed that the extreme lateral approach to the lumbar spine in case of isthmic spondylolisthesis is a reliable and safe option to the most common open procedures. In the authors' opinion, XLIF procedures allow a good correction of the listhesis associated with good clinical and radiographic results. These slides can be retrieved under Electronic supplementary material.
['Tamburrelli|Francesco Ciro|FC|', 'Meluzio|Maria Concetta|MC|', 'Burrofato|Aaron|A|', 'Perna|Andrea|A|', 'Proietti|Luca|L|']
D000328:Adult D004185:Disability Evaluation D005260:Female D006801:Humans D017116:Low Back Pain D008159:Lumbar Vertebrae D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D019060:Minimally Invasive Surgical Procedures D011859:Radiography D013123:Spinal Fusion D013168:Spondylolisthesis D016896:Treatment Outcome
Isthmic spondylolisthesis Extreme lateral interbody fusion XLIF MIS Spondylolysis