Outcome of minimally invasive transforaminal lumbar interbody fusion for the treatment of low grade (grade I and II) spondylolisthesis in obese patients

Authors

  • Anowarul Islam Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • Zafri Ahmed Ahmed Department of Spine Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • Sagor Kumar Sarker Spine Unit, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • M. Sariful Hasan Department of Orthopaedic Surgery, East West Medical College, Dhaka, Bangladesh
  • A. H. M. Masiur Rahman National Institute of Traumatology & Orthopedic Rehabilitation, Dhaka, Bangladesh
  • Khandoker Abdur Rahim Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20252624

Keywords:

BSMMU, Minimally invasive transforaminal lumbar interbody fusion, MIS TLIF, Spondylolisthesis

Abstract

Background: Spondylolisthesis in obese patient is one of the causes of back pain, severe morbidity, and impairment. This study examines low-grade spondylolisthesis patients' pain relief, functional improvement, fusion rates, and complications after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).

Methods: This study was conducted in the Department of Orthopedic Surgery at BSMMU, Dhaka, from July 2023 to June 2024. 30 low-grade spondylolisthesis patients were included according to selection criteria. Functional outcomes were assessed by Visual Analogue Scale score, Oswestry disability index, Modified Macnab’s Criteria. Interbody fusion was evaluated by Bridwell interbody fusion grading system and also perioperative events were noted.  Mean, standard deviation, Frequency and percentage were used to test qualitative data with chi-square. SPSS 26 data analyses will consider p-values <0.05 significant.

Results: 23.33% patients were day laborer and housewives. Most commonly involved level was L5/S1 (60%), followed by L4/L5, (40 peri-operative complications were seen in 4 (13.33%) patients where in 2 (6.67%) patients had seroma, 1(3.33%) patient had discitis and 1(3.33%) patient had foot drop. One patient had discitis and 1 patient had foot drop. VAS score and Oswestry Disability Index Score had showed significant improvement in post-operative follow up (at 6 months) compared to pre-operative status (p<0.05). Overall, excellent improvement was seen in 40% of cases according to modified Macnab’s criteria on 6 months of post-operative follow up.

Conclusions: MIS TLIF is a safe, efficient, and cost-effective technique when performed accurately. The reduced surgical invasiveness, shortened hospital stay, and rapid return to employment represent substantial advantages of MIS TLIF.

 

Metrics

Metrics Loading ...

References

Cofano F, Perna GD, Bongiovanni D, Roscigno V, Baldassarre BM, Petrone S, et al. Obesity and spine surgery: a qualitative review about outcomes and complications. Is it time for new perspectives on future researches?. Global Spine J. 2022;12(6):1214-30. DOI: https://doi.org/10.1177/21925682211022313

Bookshelf_NBK44178’.

Chen YC, Zhang L, Li EN, Ding LX, Zhang GA, Hou Y, Yuan W. An updated meta-analysis of clinical outcomes comparing minimally invasive with open transforaminal lumbar interbody fusion in patients with degenerative lumbar diseases. Medicine. 2019;98(43):e17420. DOI: https://doi.org/10.1097/MD.0000000000017420

He LC, Wang YX, Gong JS, Griffith JF, Zeng XJ, Kwok AW, et al. Prevalence and risk factors of lumbar spondylolisthesis in elderly Chinese men and women. Europ Radiol. 2014;24(2):441-8. DOI: https://doi.org/10.1007/s00330-013-3041-5

Demir-Deviren S, Ozcan-Eksi EE, Sencan S, Cil H, Berven S. Comprehensive non-surgical treatment decreased the need for spine surgery in patients with spondylolisthesis: three-year results. J Back Musculoskel Rehabil. 2019;32(5):701-6. DOI: https://doi.org/10.3233/BMR-181185

Dimar JR, Kuo CC. Decompression and Spinal Fusion in Low-Grade Spondylolisthesis. InSpondylolisthesis: Diagnosis, Non-Surgical Management, and Surgical Techniques. Cham: Springer International Publishing; 2023:175-189. DOI: https://doi.org/10.1007/978-3-031-27253-0_13

Rahman MM, Mohiuddin AM, Salauddin A, Kashem TB, Islam MS, Ahsan MA, et al. Outcome of Lumbar Interbody Fusion and Posterior Instrumentation in Spondylolisthesis. IAR J Medi Surg Res. 2024;5(5):25-31. DOI: https://doi.org/10.70818/iarjmsr.2024.v05i05.0132

Serban D, Calina N, Tender G. Standard versus minimally invasive transforaminal lumbar interbody fusion: a prospective randomized study. BioMed Res Inter. 2017;2017(1):7236970. DOI: https://doi.org/10.1155/2017/7236970

Qin R, Liu B, Zhou P, Yao Y, Hao J, Yang K, et al. Minimally invasive versus traditional open transforaminal lumbar interbody fusion for the treatment of single-level spondylolisthesis grades 1 and 2: a systematic review and meta-analysis. World Neurosurg. 2019;122:180-9. DOI: https://doi.org/10.1016/j.wneu.2018.10.202

Adogwa O, Carr K, Thompson P, Hoang K, Darlington T, Perez E, et al. A prospective, multi-institutional comparative effectiveness study of lumbar spine surgery in morbidly obese patients: does minimally invasive transforaminal lumbar interbody fusion result in superior outcomes?. World Neurosurg. 2015;83(5):860-6. DOI: https://doi.org/10.1016/j.wneu.2014.12.034

Wang XW, Chen X, Fu Y, Chen X, Zhang F, Cai HP, et al. Analysis of lumbar lateral instability on upright left and right bending radiographs in symptomatic patients with degenerative lumbar spondylolisthesis. BMC Musculosk Disor. 2022;23(1):59. DOI: https://doi.org/10.1186/s12891-022-05017-1

Wang J, Zhou Y, Zhang ZF, Li CQ, Zheng WJ, Liu J. Comparison of one-level minimally invasive and open transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2. Europ Spine J. 2010;19(10):1780-4. DOI: https://doi.org/10.1007/s00586-010-1404-z

Nakajima Y, Takaoki K, Akahori S, Motomura A, Ohara Y. A review of fully endoscopic lumbar interbody fusion. J Min Inv Spine Surg Tech. 2023;8(2):177-85. DOI: https://doi.org/10.21182/jmisst.2023.00997

Downloads

Published

2025-08-25

How to Cite

Islam, A., Ahmed, Z. A., Sarker, S. K., Hasan, M. S., Rahman, A. H. M. M., & Rahim, K. A. (2025). Outcome of minimally invasive transforaminal lumbar interbody fusion for the treatment of low grade (grade I and II) spondylolisthesis in obese patients . International Journal of Research in Orthopaedics, 11(5), 996–1000. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20252624

Issue

Section

Original Research Articles