PMID- 36264190
OWN - NLM
STAT- MEDLINE
DCOM- 20221024
LR  - 20221024
IS  - 1940-5480 (Electronic)
IS  - 1067-151X (Linking)
VI  - 30
IP  - 21
DP  - 2022 Nov 1
TI  - Single-level Minimally Invasive Transforaminal Lumbar Interbody Fusion Versus 
      Anterior Lumbar Interbody Fusion for the Surgical Treatment of Isthmic 
      Spondylolisthesis.
PG  - e1382-e1390
LID - 10.5435/JAAOS-D-21-01152 [doi]
AB  - INTRODUCTION: Limited studies have compared minimally invasive transforaminal 
      lumbar interbody fusion (MIS TLIF) with anterior lumbar interbody fusion (ALIF) 
      for the treatment of isthmic spondylolisthesis. This study aims to compare 
      perioperative variables, patient-reported outcome measures (PROMs), and minimal 
      clinically important difference (MCID) achievement rates between these surgical 
      approaches. METHODS: Patients with isthmic spondylolisthesis undergoing primary, 
      single-level MIS TLIF or ALIF were identified in a surgical database. Patients 
      were divided into MIS TLIF and ALIF cohorts. Demographics and perioperative 
      characteristics were collected and compared between groups using the chi square 
      test or Student t-test. PROMs including the Patient-Reported Outcomes Measurement 
      Information System Physical Function, 12-Item Short Form Physical Composite 
      Score, visual analog scale (VAS) back, VAS leg, and Oswestry Disability Index 
      were collected at preoperative, 6-, 12-week, 6-month, 1-, and 2-year time points. 
      Mean PROMs were compared using the Student t-test for independent samples. MCID 
      attainment was determined using established values in the literature; achievement 
      rates by grouping were compared using chi square analysis. RESULTS: One hundred 
      seventy-one patients were included, 121 MIS TLIF and 50 ALIF. No demographic 
      differences were observed. Mean surgical times were 139.7 minutes (MIS TLIF) and 
      165.5 minutes (ALIF) (P < 0.001). No other perioperative differences were 
      observed. Mean estimated blood loss values were 63.8 mL (MIS TLIF) and 73.7 mL 
      (ALIF). Mean postoperative lengths of stay were 43.9 hours (MIS TLIF) and 42.5 
      hours (ALIF). Mean PROMs did not markedly differ among groups at any time point. 
      MCID attainment was markedly higher among MIS TLIF patients for the Oswestry 
      Disability Index at 6 weeks (P = 0.046) and 12 weeks (P = 0.007), 
      Patient-Reported Outcomes Measurement Information System Physical Function at 12 
      weeks (P = 0.015), and VAS leg at 6 weeks (P = 0.031) and 12 weeks (P = 0.045). 
      No other notable differences were observed among MCID achievement by grouping. 
      DISCUSSION: While single-level ALIF demonstrated markedly higher surgical times, 
      other perioperative characteristics and PROMs were comparable among ALIF and MIS 
      TLIF patients. Although MCID achievement rates were generally lower for 
      disability and leg pain among ALIF patients, significance was not reached at 6 
      months, 1 year, or during the overall postoperative period after fusion.
CI  - Copyright (c) 2022 by the American Academy of Orthopaedic Surgeons.
FAU - Patel, Madhav R
AU  - Patel MR
AD  - From the Department of Orthopaedic Surgery, Rush University Medical Center, 
      Chicago, IL.
FAU - Jacob, Kevin C
AU  - Jacob KC
FAU - Pawlowski, Hanna
AU  - Pawlowski H
FAU - Prabhu, Michael C
AU  - Prabhu MC
FAU - Vanjani, Nisheka N
AU  - Vanjani NN
FAU - Singh, Kern
AU  - Singh K
AUID- ORCID: 0000-0002-6118-7273
LA  - eng
PT  - Journal Article
DEP - 20220913
PL  - United States
TA  - J Am Acad Orthop Surg
JT  - The Journal of the American Academy of Orthopaedic Surgeons
JID - 9417468
SB  - IM
MH  - Humans
MH  - *Spondylolisthesis/surgery
MH  - *Spinal Fusion
MH  - Lumbar Vertebrae/surgery
MH  - Treatment Outcome
MH  - Lumbosacral Region/surgery
EDAT- 2022/10/21 06:00
MHDA- 2022/10/25 06:00
CRDT- 2022/10/20 10:06
PHST- 2021/11/19 00:00 [received]
PHST- 2022/05/26 00:00 [accepted]
PHST- 2022/10/20 10:06 [entrez]
PHST- 2022/10/21 06:00 [pubmed]
PHST- 2022/10/25 06:00 [medline]
AID - 00124635-202211010-00013 [pii]
AID - 10.5435/JAAOS-D-21-01152 [doi]
PST - ppublish
SO  - J Am Acad Orthop Surg. 2022 Nov 1;30(21):e1382-e1390. doi: 
      10.5435/JAAOS-D-21-01152. Epub 2022 Sep 13.