Treatment of Multilevel Degenerative Lumbar Spinal Stenosis with Spondylolisthesis Using a Combination of Microendoscopic Discectomy and Minimally Invasive Transforaminal Lumbar Interbody Fusion

Overview

Journal Exp Ther Med

Specialty Pathology

Date 2013 Feb 14

PMID 23403827

Citations 9

Authors

Han Wu

Wei-Dong Yu

Rui Jiang

Zhong-Li Gao

Affiliations

Soon will be listed here.

Abstract

Degenerative lumbar spinal stenosis (DLSS) has become increasingly common and is characterized by multilevel disc herniation and lumbar spondylolisthesis, which are difficult to treat. The current study aimed to evaluate the short-term clinical outcomes and value of the combined use of microendoscopic discectomy (MED) and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) for the treatment of multilevel DLSS with spondylolisthesis, and to compare the combination with traditional posterior lumbar interbody fusion (PLIF). A total of 26 patients with multilevel DLSS and spondylolisthesis underwent combined MED and MI-TLIF surgery using a single cage and pedicle rod-screw system. These cases were compared with 27 patients who underwent traditional PLIF surgery during the same period. Data concerning incision length, surgery time, blood loss, time of bed rest and Oswestry Disability Index (ODI) score prior to and following surgery were analyzed statistically. Statistical significance was reached in terms of incision length, blood loss and the time of bed rest following surgery (P<0.05), but there was no significant difference between the surgery time and ODI scores of the two groups. The combined use of MED and MI-TLIF has the advantages of reduced blood loss, less damage to the paraspinal soft tissue, shorter length of incision, shorter bed rest time, improved outcomes and shorter recovery times and has similar short-term clinical outcomes to traditional PLIF.

Citing Articles

Unilateral Biportal Endoscopic Discectomy versus Microendoscopic Discectomy for the Treatment of Lumbar Spinal Stenosis: A Systematic Review and Meta-Analysis.

Niu Y, Shen Z, Li H Comput Math Methods Med. 2022; 2022:7667463.

PMID: 36188105 PMC: 9519329. DOI: 10.1155/2022/7667463.

Patients concerns about spinal surgery in Hafr Al Batin, Saudi Arabia.

Mohammed Z, Almutairi A, Almutairi A, Alghamdi A, Mashhur R, Alyamani A J Family Med Prim Care. 2021; 9(12):6183-6185.

PMID: 33681061 PMC: 7928091. DOI: 10.4103/jfmpc.jfmpc_450_19.

Clinical efficacy and radiographic K-rod stabilization for the treatment of multilevel degenerative lumbar spinal stenosis.

Fu C, Chen T, Yang Y, Yang H, Diao M, Zhang G BMC Musculoskelet Disord. 2020; 21(1):437.

PMID: 32631336 PMC: 7336485. DOI: 10.1186/s12891-020-03466-0.

Defining the MIS-TLIF: A Systematic Review of Techniques and Technologies Used by Surgeons Worldwide.

Lener S, Wipplinger C, Hernandez R, Hussain I, Kirnaz S, Navarro-Ramirez R Global Spine J. 2020; 10(2 Suppl):151S-167S.

PMID: 32528800 PMC: 7263344. DOI: 10.1177/2192568219882346.

The limited area decompression, intervertebral fusion, and pedicle screw fixation for treating degenerative lumbar spinal stenosis with instability: Follow-up at least 12 months an observational study.

Yang F, Ren E, Yang L, Wang Y, Hu X, Yang Y Medicine (Baltimore). 2019; 98(50):e18277.

PMID: 31852100 PMC: 6922491. DOI: 10.1097/MD.0000000000018277.

References

Pao J, Chen W, Chen P . Clinical outcomes of microendoscopic decompressive laminotomy for degenerative lumbar spinal stenosis. Eur Spine J. 2009; 18(5):672-8. PMC: 3234002. DOI: 10.1007/s00586-009-0903-2. View

Ikuta K, Tono O, Oga M . Clinical outcome of microendoscopic posterior decompression for spinal stenosis associated with degenerative spondylolisthesis--minimum 2-year outcome of 37 patients. Minim Invasive Neurosurg. 2008; 51(5):267-71. DOI: 10.1055/s-0028-1082314. View

Lee C, Rauschning W, Glenn W . Lateral lumbar spinal canal stenosis: classification, pathologic anatomy and surgical decompression. Spine (Phila Pa 1976). 1988; 13(3):313-20. DOI: 10.1097/00007632-198803000-00015. View

Katz J, Lipson S, Chang L, LEVINE S, Fossel A, Liang M . Seven- to 10-year outcome of decompressive surgery for degenerative lumbar spinal stenosis. Spine (Phila Pa 1976). 1996; 21(1):92-8. DOI: 10.1097/00007632-199601010-00022. View

Wu R, Fraser J, Hartl R . Minimal access versus open transforaminal lumbar interbody fusion: meta-analysis of fusion rates. Spine (Phila Pa 1976). 2010; 35(26):2273-81. DOI: 10.1097/BRS.0b013e3181cd42cc. View

Spivak J . Degenerative lumbar spinal stenosis. J Bone Joint Surg Am. 1998; 80(7):1053-66. DOI: 10.2106/00004623-199807000-00015. View

Park D, An H, Lurie J, Zhao W, Tosteson A, Tosteson T . Does multilevel lumbar stenosis lead to poorer outcomes?: a subanalysis of the Spine Patient Outcomes Research Trial (SPORT) lumbar stenosis study. Spine (Phila Pa 1976). 2010; 35(4):439-46. PMC: 2886146. DOI: 10.1097/BRS.0b013e3181bdafb9. View

Zouboulis P, Panagiotis Z, Karageorgos A, Athanasios K, Dimakopoulos P, Panagiotis D . Functional outcome of surgical treatment for multilevel lumbar spinal stenosis. Acta Orthop. 2006; 77(4):670-6. DOI: 10.1080/17453670610012773. View

Kim Y, Park S, Oh I, Kwan J . The clinical effect of gait load test in two level lumbar spinal stenosis. Asian Spine J. 2010; 3(2):96-100. PMC: 2852081. DOI: 10.4184/asj.2009.3.2.96. View

10.

Ozgur B, Yoo K, Rodriguez G, Taylor W . Minimally-invasive technique for transforaminal lumbar interbody fusion (TLIF). Eur Spine J. 2005; 14(9):887-94. DOI: 10.1007/s00586-005-0941-3. View

11.

Schizas C, Tzinieris N, Tsiridis E, Kosmopoulos V . Minimally invasive versus open transforaminal lumbar interbody fusion: evaluating initial experience. Int Orthop. 2008; 33(6):1683-8. PMC: 2899194. DOI: 10.1007/s00264-008-0687-8. View

12.

Pons T, Shipton E . Multilevel lumbar fusion and postoperative physiotherapy rehabilitation in a patient with persistent pain. Physiother Theory Pract. 2010; 27(3):238-45. DOI: 10.3109/09593985.2010.483268. View

13.

Haba K, Ikeda M, Soma M, Yamashima T . Bilateral decompression of multilevel lumbar spinal stenosis through a unilateral approach. J Clin Neurosci. 2005; 12(2):169-71. DOI: 10.1016/j.jocn.2004.05.016. View

14.

Hackenberg L, Halm H, Bullmann V, Vieth V, Schneider M, Liljenqvist U . Transforaminal lumbar interbody fusion: a safe technique with satisfactory three to five year results. Eur Spine J. 2005; 14(6):551-8. PMC: 3489237. DOI: 10.1007/s00586-004-0830-1. View

15.

Sasai K, Umeda M, Maruyama T, Wakabayashi E, Iida H . Microsurgical bilateral decompression via a unilateral approach for lumbar spinal canal stenosis including degenerative spondylolisthesis. J Neurosurg Spine. 2008; 9(6):554-9. DOI: 10.3171/SPI.2008.8.08122. View

16.

Vaccaro A . Unilateral approach for microsurgical decompression. J Neurosurg Spine. 2008; 9(6):552-3. DOI: 10.3171/SPI.2008.8.08561. View