Comparative Study of Sagittal Spinopelvic Parameters and Clinical Outcomes After Minimally Invasive Versus Open Fusion in Mild Isthmic Lumbar Spondylolisthesis
Retrospective comparative study shows minimally invasive fusion matches open surgery spinopelvic correction in lumbar spondylolisthesis, indicating reduced perioperative morbidity.
Key Points
To compare the radiographic spinopelvic parameters and clinical functional outcomes of minimally invasive transforaminal lumbar interbody fusion versus open posterior lumbar fusion in patients with mild isthmic spondylolisthesis.
Retrospective comparative analysis evaluated patients with single-level mild isthmic lumbar spondylolisthesis treated with either minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) or open posterior lumbar fusion.
Sagittal spinopelvic parameters (PI, PT, SS, LL, DH, SD) were evaluated preoperatively and 3 months postoperatively using quantitative image-processing software, and functional outcomes were assessed using the Oswestry Disability Index (ODI).
Both techniques significantly restored PT, SS, LL, DH, and SD (all P=0.021–0.038) without changing PI (P=0.412), with greater restoration of LL and DH correlating with improved ODI scores (r=0.64, P=0.001 and r=0.59, P=0.003, respectively).
Overall functional clinical outcomes did not differ significantly between groups (P=0.284), though the minimally invasive cohort demonstrated a significantly shorter hospital stay and faster early recovery (P=0.018).
Software-assisted quantitative radiographic measurements demonstrated strong measurement reliability across the cohort (ICC=0.93).