Complications in Minimally Invasive Versus Open Surgery for Intermediate- to High-Grade Spondylolisthesis: A 10-Year Retrospective, Multicenter Experience. (1st September 2019)

• Record Type: Journal Article
• Authors: Lak, Asad Mehmood; Abunimer, Abdullah M; Rahimi, Amina; Tafel, Ian; Zaidi, Hasan Aqdas
• Is Part Of: Neurosurgery. Volume 66(2010)Supplement 1
• Publication Date: 2019-09-01
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyz310_820
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: High-grade spondylolisthesis is a relatively uncommon condition. The optimal surgical approach for management remains debatable. Although in-situ fusion is preferred due to its lower risk of neural injury, it does not correct spinal alignment. In contrast, reduction corrects the deformity and provides a high rate of fusion, but has the potential for high rates of neural injury. We herein report our experience and surgical outcomes following minimally invasive versus open management of intermediate- to high-grade spondylolisthesis. METHODS: A multicenter, retrospective cohort analysis of adult patients aged more than 18 yr with grade II or higher spondylolisthesis, who underwent surgery from January 2008 until February 2019, was performed. RESULTS: Sixty-two patients were included in the final analysis. A total of 41 patients were treated with an open approach and 21 with a minimally invasive surgical approach (MIS). More specifically, 18 patients underwent in-situ fusion, 11 underwent MIS reduction, and 33 had an open reduction. The total rate of complications was 40.3%. The rate of complications in the MIS group was 52.3% compared to 34.1% in the open surgery group ( P = .166). The rate of complications was 27.8% in the in-situ fusion group, 72.7% in the MIS-reduction group, and 36.4% in the open-reduction group. Our comparisons of the rate of complications in the no-reduction group vs the MIS-reduction group, and the MIS-reduction group vs the open-reduction group were statistically significant ( P = .027 and P = .07, respectively). However, there was no statistically significant difference between the rate of complications in the no-reduction group vs the open-reduction group ( P = .757), nor between the rate of complications in the MIS group vs the open surgery group ( P = .166). CONCLUSION: MIS reduction is associated with a high rate of complications in the management of high-grade spondylolisthesis.