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Postoperative adjacent segment disease in minimally-invasive transforaminal lumbar interbody fusion with adjacent laminectomy for grade I-II spondylolisthesis and adjacent spinal stenosis – Lumbar Spinal Stenosis

The article reports on a study investigating the outcomes of simultaneous minimally-invasive surgical transforaminal lumbar interbody fusion (MISTLIF) and adjacent-level laminectomy for patients with low-grade spondylolisthesis and adjacent spinal stenosis. The retrospective analysis found that the procedure had a favorable safety profile, with lower rates of postoperative adjacent segment disease (ASD) compared to traditional open fusion methods. The study suggests that MISTLIF with adjacent-level laminectomy may offer a more durable result for patients in need of spinal fusion surgery. Further prospective studies are needed to confirm these findings

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top day surgery spinal centre in London

Published article

CONCLUSION: MISTLIF with adjacent-level laminectomy demonstrated a favorable safety profile with rates of postoperative ASD lower than published rates after open fusion and on par with the published rates of ASD from MISTLIF alone. Future prospective studies may better elucidate the durability of adjacent-level laminectomies when performed alongside MISTLIF, but retrospective data suggests it is safe and durable.

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World Neurosurg. 2024 Apr 6:S1878-8750(24)00564-3. doi: 10.1016/j.wneu.2024.04.002. Online ahead of print. ABSTRACT BACKGROUND AND OBJECTIVES: Studies have demonstrated increased risk of adjacent segment disease (ASD) after open fusion with adjacent-level laminectomy, with rates ranging from 16-47%, potentially related to disruption of the posterior ligamentous complex. Minimally-invasive surgical (MIS) approaches may offer a more durable result.,

World Neurosurg. 2024 Apr 6:S1878-8750(24)00564-3. doi: 10.1016/j.wneu.2024.04.002. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Studies have demonstrated increased risk of adjacent segment disease (ASD) after open fusion with adjacent-level laminectomy, with rates ranging from 16-47%, potentially related to disruption of the posterior ligamentous complex. Minimally-invasive surgical (MIS) approaches may offer a more durable result. We report institutional outcomes of simultaneous MIS transforaminal lumbar interbody fusion (MISTLIF) and adjacent-level laminectomy for patients with low grade spondylolisthesis and adjacent spinal stenosis.

METHODS: Retrospective analysis was performed on patients who underwent MISTLIF with adjacent level laminectomy to treat grade I-II spondylolisthesis with adjacent stenosis at a single institution from 2007-2022.

RESULTS: 34 patients met criteria with mean follow-up of 23.1 months. In total, 37 levels were fused and 45 laminectomies performed. 21 patients received a single level laminectomy and single level MISTLIF, 10 patients received a two-level laminectomy and single level MISTLIF, two patients received a single level laminectomy and two-level MISTLIF, and one patient received a two-level laminectomy and two-level MISTLIF. Three (8.8%) patients experienced clinically significant postoperative ASD requiring reoperation. Three other patients required reoperation for other reasons. Multiple logistic regression did not reveal any association between development of ASD and surgical covariates.

CONCLUSION: MISTLIF with adjacent-level laminectomy demonstrated a favorable safety profile with rates of postoperative ASD lower than published rates after open fusion and on par with the published rates of ASD from MISTLIF alone. Future prospective studies may better elucidate the durability of adjacent-level laminectomies when performed alongside MISTLIF, but retrospective data suggests it is safe and durable.

PMID:38588790 | DOI:10.1016/j.wneu.2024.04.002

The London Spine Unit : top day surgery spinal centre in London

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Postoperative adjacent segment disease in minimally-invasive transforaminal lumbar interbody fusion with adjacent laminectomy for grade I-II spondylolisthesis and adjacent spinal stenosis

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World Neurosurg. 2024 Apr 6:S1878-8750(24)00564-3. doi: 10.1016/j.wneu.2024.04.002. Online ahead of print. ABSTRACT BACKGROUND AND OBJECTIVES: Studies have demonstrated increased risk of adjacent segment disease (ASD) after open fusion with adjacent-level laminectomy, with rates ranging from 16-47%, potentially related to disruption of the posterior ligamentous complex. Minimally-invasive surgical (MIS) approaches may offer a more durable result.

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