Clinical and Radiological Evaluation of Percutaneous Trans-Pedicular Screw Fixation in Management of Low Grade Spondylolisthesis

Background: When treating low-grade spondylolisthesis, transforaminal interbody fusion (TLIF) can offer a safe procedure with high fusion and few problems. The aim of this work was to improve clinical and radiological outcomes of patients with low grade spondylolisthesis by performing percutaneous transpedicular screw fixation. Methods: Eighteen patients 13 males (72%) and 5 females (28%) with low-grade isthmic spondylolisthesis operated with TLIF. Clinical and functional outcome was assessed on Visual analogue Scale (VAS) and Oswestry Disability Index (ODI). The follow up period of the series was 6 months. 6 patients were L5-S1 and 11 were L4-L5. Results: All the patients underwent interbody fusion using the MIS-TLIF technique augmented with posterior percutaneous pedicle screws placement. Mean operative time for all cases was (70.72 ± 13.77 min) and the mean blood loss was (50.64 ± 11.35). By grading the patients according to the patient satisfaction index (PSI); it was found that in 15 patients (83.33%) surgery met their expectations (grade I), 3 patients (16.7%) were grade II. There were no major systemic complications. Two cases were complicated by subcutaneous hematoma, and one patient was complicated with superficial wound infection. But None of them has any neurological deficit till the final follow up. Conclusion: MIS-TLIF is a safe method of managing low grade isthmic spondylolisthesis with obvious improvement in clinical and radiological outcome of these patients.