The different impact on saggital spinopelvic alignment in degenerative spondylolisthesis between minimally invasive transforaminal lumbar interbody fusion and conventional open posterior lumbar interbody fusion

English Keywords:Minimally invasive  Open  Degenerative spondylolisthesis  Saggital alignment  Comparison

English Abstract:

  【Abstract】 Objectives: To compare the different impact on saggital spinopelvic alignment in degenerative spondylolisthesis between minimally invasive transforaminal lumbar interbody fusion(TLIF) and conventional open posterior lumbar interbody fusion(PLIF). Methods: From June 2010 to June 2013, 48 patients with L4 single segmental degenerative spondylolisthesis met the inclusion criteria underwent traditional open PLIF in 23 cases(OPEN group) and minimally invasive TLIF in 25 cases(MIS group), and the clinical data were analyzed retrospectively. The following data of preoperation and final follow-up were compared between the two groups on the standing lateral lumbar X-ray which containing bilateral femoral heads: slip percentage(SP), lumbar lordosis(LL), pelvic incidence(PI), pelvic tilt(PT), sacral slop(SS), lumbosacral angle(LSA), slip angle(SA) and the L1 axis and S1 distance(LASD). The correlation between the parameters was analyzed using correlate analysis. Results: The rate of slip reduction(ΔSP) in OPEN group was (67.42±33.80)%, which was significantly higher than that in MIS group (36.59±50.68)%(P<0.05). The LL at final follow-up was 43.03°±14.07°, SA was 3.12°±4.02°, which were both significantly lower than preoperative ones(46.53°±15.72° and 6.10°±5.64° respectively) in MIS group(P<0.05). ΔSA in OPEN group was 2.53°±6.63°, which was significantly higher than that in MIS group(-2.98°±5.42°)(P<0.05). ΔLASD in OPEN group was -4.10°±14.53°, which was significantly lower than that in MIS group(3.48°±9.01°)(P<0.05). There were positive correlations between preoperative SP and LASD, ΔSA and ΔLL, and negative correlation between ΔLL and ΔPT. Conclusions: For degenerative spondylolisthesis, minimally invasive TLIF and open PLIF all can make a significant reduction to slippage vertebral, but open PLIF has a higher rate of slip reduction. Minimally invasive TLIF significant reduce LL and SA, resulting in relative kyphosis on fusion segment. Open PLIF significant reduce LASD, is more conductive to improve sagittal spinopelvic balance.