[Treatment of degenerative lumbar spondylolisthesis by transforaminal lumbar interbody fusion with microendoscopic surgery]

Abstract

Objective: To investigate the effect of treating degenerative lumbar spondylolisthesis by transforaminal lumbar interbody fusion with microendoscopic surgery.

Methods: From Jan. 2006 to Jan. 2009, one hundred fifty patients who underwent transforaminal lumbar interbody fusion with microendoscopic surgery were analyzed retrospectively. The diagnosis was degenerative lumbar spondylolisthesis in 84 cases of grade I, and 66 cases of grade II. There were 88 males and 62 females. Preoperatively, at 1 week and 3 months postoperatively, the pain was evaluated with visual analogue scale (VAS) scoring system and therapeutic effect was observed with modified Prolo scoring system.

Results: In complications, dural tear happened in 3 cases, biological glues were used for dural tear sealing and neither cerebrospinal fluid leak was found. One case suffered from intervertebral Infection and muscle weakness of foot was found in one case, either was cured after symptomatic treatment. Operative time averaged 160 minutes (120-280 min). Estimated blood loss averaged 210 ml (100-450 ml). The postoperative follow-up ranged from 6 to 36 months (averaged 15.2 months). Preoperatively,at 1 week and 3 months postoperatively, VAS scores were respectively 7.9 +/- 2.1, 2.2 +/- 0.6, 3.2 +/- 1.1 (P < 0.01). The rate of excellent and good was 98.67% (148/150) according to modified Prolo scoring system.

Conclusion: Microendoscopic surgery transforaminal lumbar interbody fusion technique is indicated for lumbar vertebral instability, localized intervertebral disc disorder and lumbar spondylolisthesis with stenotic nerve root or tube below grade II. This technique has advantages of minimal invasion and early functional recovery.