Minimal access versus open posterior lumbar interbody fusion in the treatment of spondylolisthesis

Abstract

Objective: To compare the safety and effectiveness of minimal access posterior lumbar interbody fusion (MAPLIF) with open posterior lumbar interbody fusion (OPLIF) in patients with spondylolisthesis and radicular pain.

Methods: A prospective study was performed of 47 patients with radicular pain resulting from lumbar spondylolisthesis with a slip of less than 50% who underwent either MAPLIF (n = 23) or OPLIF (n = 24). At 12 months after treatment, clinical outcomes were measured using the Short-Form Health Survey 36 and the visual analog score for both leg pain and back pain, and the degree of reduction of spondylolisthesis, restoration of disc height, and presence of fusion were assessed.

Results: Both groups were similar in demographic and baseline clinical features. Both exhibited statistically and clinically significant improvements in back pain (OPLIF, 64%; MAPLIF, 78%), and leg pain (88% for both groups). This was corroborated by improvements in social and physical functioning, which were similar for both groups. The reduction of spondylolisthesis and fusion rates were also similar between the 2 groups. MAPLIF patients commenced mobilization sooner, achieved independent mobilization earlier, and had a shorter hospital stay (4 days versus 7 days).

Conclusion: MAPLIF and OPLIF both reduce leg and back pain and restore function to a similar extent. MAPLIF is as effective as OPLIF in reducing the slip in patients with spondylolisthesis of less than 50%. MAPLIF promotes faster recovery and shortens hospital stay.