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High fusion rates at 2 years seen with MIS XLIF, MIS TLIF for degenerative spondylolisthesis
Although minimally invasive extreme lateral interbody fusion and minimally invasive transforaminal lumbar interbody fusion showed significantly different radiographic characteristics, both approaches for the treatment of degenerative spondylolisthesis had significant clinical improvements and high fusion rates at 2 years, according to study results.
Researchers prospectively compared the clinical and radiographic outcomes of 55 patients who underwent surgery with either minimally invasive extreme lateral interbody fusion (MIS XLIF) approach or MIS transforaminal lumbar interbody fusion (MIS TLIF) for degenerative spondylolisthesis with spinal stenosis at either one or two contiguous levels from L1 to L5. Investigators collected data on patient demographics, diagnosis, past medical history, work status, symptoms and comorbidities.
At baseline and at 6-weeks, 12-weeks, 6-months, 12-months and 24-months postoperatively, patient-reported outcomes were collected including the Oswestry Disability Index, VAS and SF-36 physical and mental component scores. Investigators obtained MRI scans preoperatively and at 3-months postoperatively and CT scans after 12 months.
Results showed disc height improved significantly for both groups at all postoperative follow-ups, although patients who underwent XLIF had less subsidence and resultant disc height loss at 24-months postoperatively than patients in the MIS TLIF group. The MIS TLIF group had a significantly greater postoperative change in the central canal area than the MIS XLIF group.
Investigators noted that during several postoperative follow-ups, the foraminal height and area on ipsilateral side and foraminal height on the contralateral side had increased significantly in patients who underwent XLIF. There was a significant increase in the magnitude of the ipsilateral height in patients who underwent MIS TLIF. ‒ by Monica Jaramillo
Disclosures: Isaacs reports he receives IP royalties, is a paid consultant and receives research support from Nuvasive. He also has stock or stock options in Providence, Safewire, Vertera and Vilaspine. Please see the full study for a list of all other authors’ relevant financial disclosures.