Efficacy and safety of lumbar interbody fusion with larger-diameter endoscope of spine surgery for spondylolisthesis
QI Jiakun
DONG Jianwen
LIU Zhongyu
CHEN Zihao
CHEN Ruiqiang
YANG Yang
RONG Limin
Abstract：Objective To explore the efficacy and safety of lumbar interbody fusion with larger-diameter spinal endoscope for the treatment of lumbar spondylolisthesis.Methods A total of 72 patients who underwent single-level lumbar interbody fusion with larger-diameter endoscope from June 2018 to November 2022 in the Third Affiliated Hospital of Sun Yat-sen University were included.Thirty-six patients with lumbar spondylolisthesis were included in the spondylolisthesis group,including 15 cases of degenerative Grade Ⅰ spondylolisthesis,3 cases of degenerative Grade Ⅱ,11 cases of isthmic Grade Ⅰ,and 7 cases of isthmic Grade Ⅱ spondylolisthesis.The remaining 36 patients with lumbar degenerative diseases without preoperative spondylolisthesis were included in the non-spondylolisthesis group.Clinical outcomes were evaluated by using Oswestry disability index(ODI),visual analogue scale(VAS)for back and leg pain,and Japanese Orthopaedic Association(JOA)scores.All patients underwent postoperative imaging with antero-lateral lumbar X-rays and lumbar CT scans to assess decompression of the spinal canal.Fusion status was evaluated based on Bridwell criteria using CT scans obtained at least 6 months postoperatively.Results The mean follow-up period was(31.0±13.3)months(range 8 to 61 months).There were no significant differences between the spondylolisthesis and non-spondylolisthesis groups in terms of operative time,intraoperative blood loss,or length of hospital stay(P＞0.05).Both groups showed improvement in ODI,VAS scores of back pain,and leg pain,and JOA scores at the postoperative and final follow-up assessments compared to preoperative values(P＜0.05),with no statistical differences of the above indicators at the postoperation and the latest follow-up when compared between the two groups(P＞0.05).The mean postoperative disc height in the spondylolisthesis group(13.43 mm)was higher than that in the non-spondylolisthesis group(12.03 mm),with statistical differences between two groups(P＜0.05).Fusion rates in the two groups were similar(P＞0.05).No serious postoperative complications was found in either group,and the incidence of complications did not differ significantly between the groups(P＞0.05).Conclusions Lumbar interbody fusion with larger-diameter spinal endoscope is a safe and effective alternative for treatment of lumbar spondylolisthesis.However,manipulation at the L5/S1 level for isthmic Grade Ⅱ spondylolisthesis still present a great technical challenge.
Keywords：Lumbar vertebraSpondylolisthesisSpinal fusionEndoscopySpinal stenosisIntervertebral disc displacement
Publication Date：2024-02-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 8-15 )