Abstract:
Introduction. Currently, the standard treatment of degenerative spondylolisthesis involves pedicle screw fixation to
enhance the success of intervertebral fusion. The traditional pedicle screw techniques require extensive lateral muscle
dissection, resulting in significantly increased surgical-related morbidity. To address some of these shortcomings, the
Midline Lumbar Interbody Fusion (MIDLIF®) technique has recently been developed. It involves the combination of
the cortical bone trajectory screw fixation of the spine with intervertebral cage placement to achieve a solid interbody
fusion. So far, the clinical efficacy of the MIDLIF technique in the treatment of low-grade degenerative spondylolisthesis
is still unknown. All existing publications are studies with a low level of relevance or scientific evidence.
Materials and methods. A prospective randomized controlled trial was conducted between 2017 and 2022. The study
analyzed the clinical and radiological effectiveness of the MIDLIF arthrodesis technique compared to the traditional
lumbar interbody fusion techniques, used exclusively in the treatment of degenerative lumbar spondylolisthesis.
Results. The study enrolled 112 eligible patients with degenerative low-grade spondylolisthesis, randomly assigned
into two groups. At 1 year post-operatively, MIDLIF provided a significantly better improvement in postoperative relief
of low back pain and radiating pain, as well as a significantly better functional recovery. Additionally, MIDLIF resulted
in lower surgical morbidity compared to traditional fusion techniques.
Conclusions. The success rate of MIDLIF arthrodesis is similar to that associated with traditional fusion techniques. At
the same time, MIDLIF offers all the specific benefits of a minimally invasive approach, such as less postoperative pain,
faster functional recovery, less bleeding, and fewer blood transfusions. Thus, MIDLIF might be a good alternative to the
traditional intervertebral fusion techniques in the treatment of degenerative low-grade spondylolisthesis.
