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Comparison of minimally invasive fusion and instrumentation versus open surgery for severe stenotic spondylolisthesis with high-grade facet joint osteoarthritis

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Abstract

Purpose

The object of this study was to compare minimally invasive surgery (MIS) with open surgery in a severely affected subgroup of degenerative spondylolisthetic patients with severe stenosis (SDS) and high-grade facet osteoarthritis (FJO).

Methods

From January 2009 to February 2010, 49 patients with severe SDS and high-grade FJO were treated using either MIS or open TLIF. Intraoperative and diagnostic data, including perioperative complications and length of hospital stay (LOS), were collected, using retrospective chart review. Surgical short- and long-term outcomes were assessed according to the Oswestry disability index (ODI) and visual analog scale (VAS) for back and leg pain.

Results

Comparing MIS and open surgery, the MIS group had lesser blood loss, significantly lesser need for transfusion (p = 0.02), more rapid improvement of postoperative back pain in the first 6 weeks of follow-up and a shorter LOS. On the other hand, we experienced in the MIS group a longer operative time. The distribution on the postoperative ODI (p = 0.841), VAS leg (p = 0.943) and back pain (p = 0.735) scores after a mean follow-up of 2 years were similar. The overall proportion of complications showed no significant difference between the groups (29 % in the MIS group vs. 28 % in the open group, p = 0.999).

Conclusion

Minimally invasive surgery for severe SDS leads to adequate and safe decompression of lumbar stenosis and results in a faster recovery of symptoms and disability in the early postoperative period.

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Abbreviations

CSF:

Cerebrospinal fluid

CT:

Computerized tomography

EBL:

Estimated blood loss

FJO:

Facet joint osteoarthritis

LBP:

Low back pain

LOS:

Length of hospital stay

MR:

Magnetic resonance

MIS:

Minimally invasive surgery

TLIF:

Transforaminal interbody fusion

SD:

Standard deviation

SDS:

Stenotic degenerative spondylolisthesis

VAS:

Visual analog scale

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Conflict of interest

The authors report no conflict of interest concerning the materials and methods used in this study or the findings specified in this paper.

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Authors and Affiliations

  1. Department of Neurosurgery, Klinikum Offenbach, Akademisches Lehrkrankenhaus der Universität Frankfurt, Starkenburgring 66, 63069, Offenbach, Germany

    Eleftherios Archavlis

  2. Department of Neurosurgery, Klinikum Traunstein, Akademisches Lehrkrankenhaus der Universität München, Traunstein, Germany

    Mario Carvi y Nievas

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  1. Eleftherios Archavlis
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Correspondence to Eleftherios Archavlis.

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Archavlis, E., Carvi y Nievas, M. Comparison of minimally invasive fusion and instrumentation versus open surgery for severe stenotic spondylolisthesis with high-grade facet joint osteoarthritis. Eur Spine J 22, 1731–1740 (2013). https://doi.org/10.1007/s00586-013-2732-6

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  • DOI: https://doi.org/10.1007/s00586-013-2732-6

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