Reduction of high-grade lumbosacral spondylolisthesis by minimally invasive transforaminal lumbar interbody fusion: A technical note

Abstract

Objective: To demonstrate the feasibility and efficacy of reduction of high-grade lumbosacral spondylolisthesis via a minimally invasive approach. Summary of background data: Reduction of high-grade spondylolisthesis remains controversial and technically challenging. Although minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) has gained wide acceptance in recent years, it still has not been reported to achieve complete reduction of high grade slips. Methods: In this technical note, the authors present a case of L5/S1 Meyerding Grade III fixed spondylolisthesis managed by MI-TLIF with percutaneous screws. Surgical techniques and key steps for reduction are described in detail. Results: A 50-year-old woman had low back pain for 8 years. She also presented with radiculopathy of lower limbs and frequency/urgency of urination. The radiographs and computed tomography (CT) of the lumbar spine demonstrated degenerative spondylolisthesis, Meyerding grade III, at the level of L5/S1. The slippage was fixed on dynamic radiographs and there was neuroforaminal stenosis on the magnetic resonance image. The patient underwent MI-TLIF with percutaneous pedicle screw-rod fixation for arthrodesis at L5/S1. Her symptoms subsided after the operation. The one-and-half year follow-up radiographs, including CT, demonstrated complete reduction of the high-grade slippage and fusion of the lumbosacral spondylolisthesis. Conclusion: Minimally invasive TLIF is a viable option for reduction of high-grade spondylolisthesis at L5/S1.

Keywords

• Minimally invasive surgery (MIS)
• Percutaneous pedicle screw
• Spondylolisthesis
• Transforaminal lumbar interbody fusion (TLIF)