A Novel Technique for Reduction of Spondyloptosis with Minimal Access Surgery (MIS-TLIF): A Case Report

Abstract

To describe a technique for reduction of spondyloptosis with minimal access surgery. A 40-year-old female with BMI of 31.29 presented with chronic back pain and claudicant right L5 dermatomal pain (VAS 9/10) and paresthesia. Radiographs of lumbosacral spine revealed spondyloptosis at L5-S1 with a slip angle of 38° and lumbar lordosis of 100°. Minimally invasive TLIF (MIS-TLIF) using tubular retractor and percutaneous pedicle screw-rod system was planned. MIS-TLIF was successful in achieving reduction and fusion of spondyloptosis. At 12 months follow up, the VAS for back pain improved from 9/10 to 2/10 and leg pain improved from 9/10 to 1/10. The ODI improved from 80% to 19%. Lumbar lordosis improved from 100° to 60° and slip angle 38° to 60°. There was no wound site morbidity and minimal operative site pain. Radiographs at 6 months revealed no loss of reduction or loosening of implants. Minimal access reduction and fusion technique (MIS-TLIF) using cantilever mechanism is feasible, safe and clinically effective in spondyloptosis.

Keywords

• decompression
• discectomy
• laminectomy
• neuromonitoring
• minimally invasive spine surgery
• mis-tlif
• pedicle screws
• spondylolisthesis
• spondylolysis
• spondyloptosis