Comparison of O-arm navigation and microscope-assisted minimally invasive transforaminal lumbar interbody fusion and conventional transforaminal lumbar interbody fusion for the treatment of lumbar isthmic spondylolisthesis

OBJECTIVE: The objective of this study is to compare the clinical efficacy of O-arm navigation and microscope-assisted minimally invasive transforaminal lumbar interbody fusion (modified MIS-TLIF) versus conventional TLIF in the lumbar isthmic spondylolisthesis. MATERIALS AND METHODS: Forty patients with 1-level lumbar isthmic spondylolisthesis were enrolled in the study. Perioperative indexes including operation time, intraoperative bleeding, bed rest time, time of hospitalisation stay and the accuracy rate of screw placement were analysed. Preoperative and postoperative visual analogue scale (VAS) and Oswestry disability index (ODI) were assessed. RESULTS: The operation time in the modified MIS-TLIF group was longer than the conventional TLIF group (p ​< ​0.05). However, intraoperative blood loss in the modified MIS-TLIF group was less than the comparative group (p ​< ​0.05). The average bed rest time and hospitalisation stay in the modified MIS-TLIF group was shorter than conventional TLIF group (p ​< ​0.05). The screw placement in the modified MIS-TLIF group was more precisely than that in the conventional TLIF group (p ​< ​0.05). Meanwhile, the improvement of VAS and ODI in the modified MIS-TLIF group were lower than that in the conventional TLIF group 1 and 6 months after operation (p ​< ​0.05). There was no difference in the VAS and ODI score between the two group at the last follow-up (p ​> ​0.05). CONCLUSION: Navigation and microscope-assisted MIS-TLIF is safe and reliable for treatment of lumbar isthmic spondylolisthesis (Meyerding degree I or II) with potential advantages including less injury, less blood loss, higher screw accuracy and faster recovery after operation. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE: Compared with conventional transforaminal lumbar interbody fusion, O-arm navigation and microscope-assisted minimally invasive transforaminal lumbar interbody fusion has a huge advantage in surgery treatment of lumbar isthmic spondylolisthesis. Hence, this article provided a better surgery method to deal with lumbar isthmic spondylolisthesis, and robot-assisted minimally invasive transforaminal lumbar interbody fusion will be adopted in the future.