title: Bilateral tubular minimally invasive approach for decompression, reduction and fixation in lumbosacral lythic spondylolisthesis.
abstract: This video demonstrates the minimally invasive surgical technique used in a 56-year-old woman suffering from L-5 spondylolysis and grade 2 L5-S1 spondylolisthesis. The first author used expandable tubular retractors bilaterally to perform neural decompression, mini-open TLIF, spondylolysthesis reduction and L5-S1 pedicle screw fixation. L-5 cement augmentation was performed through cannulated and fenestrated screws to enhance resistance to screw pull-out secondary to reduction maneuvers. Sequential surgical steps related to microsurgery, spondylolysthesis reduction and instrumentation are shown and commented. We submit that in cases of lythic spondylolisthesis a bilateral traversing and exiting nerve roots decompression is a safer option prior to performing the deformity reduction and fixation; the proposed minimally invasive technique may help in reducing surgical morbidity and improving postoperative recovery. The video can be found here: http://youtu.be/G4Qdg-A-Y3M.
authors.affiliation: Neurosurgery Department, Policlinico G. Rodolico University Hospital, Catania, Italy. giuseppebarbagal@hotmail.com
authors.forename: Giuseppe M V
authors.initials: GM
authors.lastname: Barbagallo
authors.forename: Francesco
authors.initials: F
authors.lastname: Certo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Sciacca
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Albanese
mesh_terms: D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011843:Radiculopathy / Q000473:pathology / Q000601:surgery*; D012447:Sacrum / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013168:Spondylolisthesis / Q000175:diagnosis / Q000601:surgery*; D014741:Video Recording / Q000379:methods