Midline lumbar interbody fusion in the treatment of degenerative spondylolisthesis. Comparative study of clinical efficacy: Summary of the Ph.D. Thesis in Medical Sciences: 321.21 - Neurosurgery

Abstract

INTRODUCTION. Relevance of the issue under research. Degenerative spondylolisthesis (DSPL) is one of the most common degenerative lesions of the lumbar spine, affecting up to 14% of the population. Although there is no consensus on the optimal surgical treatment, currently the standard technique of treating patients with DSPL includes decompression of nervous structures and stabilization of the spine via one of the traditional methods of intersomatic arthrodesis (PLIF, TLIF, PLF). While being very effective in achieving intervertebral fusion, the traditional technique is associated with important drawbacks, such as the significant muscle dissection required for the insertion of pedicle screws. The traditional technique is also associated with increased surgical morbidity due to iatrogenic muscle and soft tissue injury. Long skin incisions, injury of medial branch of the spinal dorsal ramus and prolonged soft tissue retraction can cause denervation and ischemic necrosis of paravertebral muscles. Loss of functional muscle support may subsequently lead to segmental instability, increased biomechanical stress and persistence of low back pain. [...]