title: Minimally Invasive Transforaminal Lumbar Interbody Fusion (TLIF) for Spondylolisthesis in 282 Patients: In Situ Arthrodesis versus Reduction.
abstract: OBJECTIVE
  The benefits of spondylolisthesis reduction via minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) remain poorly understood. The purpose was to compare the complications, perioperative factors, and fusion rates in patients undergoing MI-TLIF for degenerative spondylolisthesis between those in whom reduction was or was not performed.
  
  
  METHODS
  
  
  
  METHODS
  1) patients who underwent a 1, 2, or 3 level MI-TLIF and 2) had a preoperative diagnosis of degenerative spondylolisthesis (Meyerding grade >0).
  
  
  METHODS
  >10° coronal curves, significant sagittal malalignment, infection, and preoperative hardware failure. Patients were grouped on the basis of those who underwent reduction of the spondylolisthesis by at least 1 Meyerding grade (RED) and those who did not (NORED).
  
  
  RESULTS
  A total of 282 patients were included: RED (162, 57.4%) and NORED (120, 42.6%). Mean ages (61.68 ± 10.43 vs. 61.88 ± 11.76 years, respectively, P > 0.05) and operative times (P > 0.05) were statistically similar. RED had a significantly larger EBL (280.2 ± 24.03 vs. 212.61 ± 17.54, P < 0.05). The length of hospital stay, intraoperative complications, postoperative medical and surgical complications, and disposition were statistically similar between groups (P > 0.05, for all). RED had a significantly higher percentage of patients with a successful fusion at 1 year than NORED (84.50% vs. 70.83%, P < 0.05).
  
  
  CONCLUSIONS
  Reduction of spondylolisthesis was not associated with an increase in operative time, length of stay, and perioperative and postoperative complications compared with fusion in situ. Reduction was associated with higher blood loss but also a higher rate of fusion success at 1 year. Overall, reduction did not incur additional risk and had positive perioperative outcomes.
authors.affiliation: Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors.forename: Justin K
authors.initials: JK
authors.lastname: Scheer
authors.affiliation: Department of Neurosurgery, The University of Chicago, Chicago, Illinois, USA.
authors.forename: Brenda
authors.initials: B
authors.lastname: Auffinger
authors.affiliation: Department of Neurosurgery, University of South Florida, Tampa, Florida, USA.
authors.forename: Ricky H
authors.initials: RH
authors.lastname: Wong
authors.affiliation: Department of Neurosurgery, The University of Chicago, Chicago, Illinois, USA.
authors.forename: Sandi K
authors.initials: SK
authors.lastname: Lam
authors.affiliation: Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors.forename: Cort D
authors.initials: CD
authors.lastname: Lawton
authors.affiliation: Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors.forename: Alexander T
authors.initials: AT
authors.lastname: Nixon
authors.affiliation: Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors.forename: Nader S
authors.initials: NS
authors.lastname: Dahdaleh
authors.affiliation: Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. Electronic address: zsmith@nmff.org.
authors.forename: Zachary A
authors.initials: ZA
authors.lastname: Smith
authors.affiliation: Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, USA.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Fessler
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D013168:Spondylolisthesis / Q000601:surgery* / Q000628:therapy*; D016896:Treatment Outcome
keywords: Complications; Fusion; Minimally invasive; Spine; Spondylolisthesis; TLIF