Percutaneous Pedicle Screw Fixation with Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion in the Treatment of Degenerative Lumbar Spondylolisthesis with Instability

OBJECTIVE: To evaluate the safety and efficacy of percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) in patients with L4-L5 degenerative lumbar spondylolisthesis (DLS) with instability. METHODS: The clinical data of 27 patients with L4-L5 DLS who underwent PE-TLIF from September 2019 to April 2022 were retrospectively reviewed. A minimum of 12 months of follow-up visits was provided to all patients. The demographics, perioperative, and clinical outcomes were reviewed based on the visual analog scale (VAS), Oswestry Disability Index (ODI), and modified MacNab criteria. Brantigan criteria estimated the result of interbody fusion at 12 months.RESULTS: The mean age was 70.70 +/- 8.91 (55-83) years. The mean +/- standard deviation values of the preoperative visual analog scale for back pain, leg pain, and Oswestry Disability Index were 7.37 +/- 1.01, 7.26 +/- 0.94, and 66.22 +/- 7.49, respectively. The values improved to 1.66 +/- 0.62, 1.74 +/- 0.52, and 19.55 +/- 5.56 at 12 months postoperatively (P < 0.05). The modified MacNab criteria revealed that 88.89% (24/27) of patients achieved good-to-excellent outcomes. The interbody fusion rate was 100% at the final follow-up.CONCLUSIONS: In patients with L4-L5 DLS with instability, PE-TLIF under conscious sedation and local anesthesia could be an effective supplement for open decompression and fusion.