Medical Student University of Illinois College of Medicine Chicago, Illinois, United States
Introduction: This study aims to compare clinical outcomes between patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) versus lateral lumbar interbody fusion (LLIF) for isthmic spondylolisthesis (IS) using patient-reported outcome measures (PROMs) and minimum clinically important difference (MCID).
Methods: Patients presenting with IS were separated into two cohorts by procedure: MIS-TLIF or LLIF. PROMs of Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF), 12-Item Short Form Physical Component Score (SF-12 PCS), Visual Analog Scale (VAS) back, VAS leg, and Oswestry Disability Index (ODI) were recorded at preoperative and 6-week, 12-week, 6-month, and 1-year postoperative time points.
Results: After propensity score matching for demographics, 118 total patients were included, with 95 patients undergoing MIS-TLIF and 23 undergoing LLIF. Patients undergoing MIS-TLIF demonstrated significant postoperative improvement in 12-week to 1-year PROMIS-PF, 6-week to 1-year SF-12 PCS, 6-week to 1-year VAS back, 6-week to 1-year VAS leg, and 12-week to 1-year ODI (p≤0.010, all). Patients undergoing LLIF reported significant postoperative improvement in 1-year PROMIS-PF, 6-month to 1-year SF-12 PCS, 6-week to 12-week VAS back, 12-week to 6-month VAS leg, 12-week ODI (p≤0.043, all). No significant differences were reported between cohorts in raw PROM scores and MCID achievement rates.
Conclusion : Patients undergoing either MIS-TLIF or LLIF for isthmic spondylolisthesis demonstrated significant postoperative improvement in physical function, pain, and disability outcomes. No significant differences in patient-reported outcomes and MCID achievement rates were reported between surgical procedures. Patients undergoing surgical intervention for isthmic spondylolisthesis may experience similar postoperative improvement when undergoing either MIS-TLIF or LLIF.
