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Is unilateral-approach full-endoscopic lumbar fusion effective for single-level lumbar spondylolisthesis with bilateral symptoms? A preliminary report of 43 CT analysis

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Abstract

Purpose

To investigate the clinical results and radiological parameters changes after unilateral-approach endoscopic lumbar interbody fusion (Endo-LIF) for lumbar spondylolisthesis with bilateral symptoms.

Methods

43 single-level lumbar spondylolisthesis patients with bilateral lower limb symptoms were included from June 2020 to May 2022. All patients underwent unilateral-approach Endo-LIF and postoperative computed tomography. Radiological parameters including disk height (DH), degree of upper vertebral slip (DUVS), and foramen intervertebral parameters including bilateral foraminal height (FH), contralateral foraminal areas (FA) were evaluated. The clinical outcomes including low back pain and bilateral leg pain were evaluated using Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI) before and after surgery.

Results

All cases were successfully completed surgery and followed for average 15.16 ± 5.2 months. DH (44% ± 11%) and DUVS were significantly improvement postoperatively compared with preoperatively (p < 0.05). Statistically significant increases in bilateral FH (25% ± 11% on the surgical side, 17% ± 8% on the contralateral side) and contralateral FA (26% ± 6%) were observed (p < 0.05). The VAS and the ODI scores were significantly decreased in comparison with the preoperative scores (p < 0.05).

Conclusion

Unilateral-approach with contralateral indirect decompression in Endo-LIF can acquire satisfactory clinical outcomes. Therefore, unilateral-approach Endo-LIF may be a promising option for lumbar spondylolisthesis with bilateral symptoms.

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Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Jiangsu Provincial Health Commission Project (LX2021015).

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Authors and Affiliations

  1. School of Medicine, Southeast University, Nanjing, 210009, China

    Xu Shen, Yu-cheng Gao, Pei Zhang, Peng Song, Zan-li Jiang, Feng Wang, Wen-bin Xuan & Zeng-xin Gao

  2. Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China

    Xu Shen, Yu-cheng Gao, Pei Zhang, Peng Song, Zan-li Jiang, Feng Wang, Wen-bin Xuan & Zeng-xin Gao

  3. Department of Orthopedics, Nanjing Lishui People’s Hospital, Zhongda Lishui Brach, Nanjing, 210009, China

    Zeng-xin Gao

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Shen, X., Gao, Yc., Zhang, P. et al. Is unilateral-approach full-endoscopic lumbar fusion effective for single-level lumbar spondylolisthesis with bilateral symptoms? A preliminary report of 43 CT analysis. Eur Spine J 33, 409–416 (2024). https://doi.org/10.1007/s00586-023-07667-8

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