Management of Lumbar Spondylolisthesis: A Retrospective Analysis of the Contribution of Minimally Invasive Surgery Toto Lumbar Spondylolisthesis

Objective: The objective of our study consists of studying the contribution of minimally invasive surgery for lumbar spondylolisthesis in patients treated in the neurosurgery department of the Ibn Sina University Hospital in the city of Rabat during a period of 8 years.

Summary of Background Data. The past two decades have witnessed a surge in minimally invasive spine surgery, mirroring advancements in other surgical disciplines. These techniques prioritize minimizing muscle damage compared to traditional approaches, thereby aiming to reduce complications associated with surgery. surgery. This study reviews the value of these approaches in the treatment of spondylolisthesis.

Study Design: Retrospective cohort study, January 2016 to January 2024.

Methodology: A retrospective analysis of 29 patients who underwent interbody fusion for lumbar stenosis using minimally invasive (MI) TLIF was performed. Patients were monitored by the by the Visual Analog Score (VAS), Meyrding score, and average percentage gain. The results of recently published series are reported.

Results: The average age of patients is 54 years, with extremes of 34 and 70 years. years. sex ratio of 6.25.

The clinical picture was dominated by low back pain in 61% as well as radiculalgia reported in 81.7%, intermittent claudication in 26.8%, in 26.8%, deficit in 15.4%, and15.4%, and sphincter disorder in 3.4%.3.4%.

In our series, the predominant location of spondylolisthesis was at the level of L4-L5 in 46% of patients and L5-S-SS1 in 42%. All patients benefited from prior medical treatment for failure. In 61.5% of patients, the failure of medical and orthopedic treatment was the indication for surgery. Surgical treatment was required in all patients in our study, using the minimally invasive transforaminal interbody fusion method. Clinically, 62% of our patients have very good progress, 26% have good progress, and 4% have average progress. Neurological recovery was required in all our patients who had previously presented a neurological deficit. The average percentage of gains in the patients included in our study is 65%, ranging from 6.6% to 100%.

Conclusion: Our study has shown the significant benefit of minimally invasive spondylolisthesis surgery carried out by well-trained practitioners. The treatment always begins with medical and orthopedic treatment, but depending on the evolution of the disease, we often resort to surgical treatment.

Minimally invasive surgery concretely meets the required objectives, in particular the reduction of the risk of hemorrhage and infection, rapid postoperative recovery, and the preservation of the muscles.