{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:02:46Z","timestamp":1780131766305,"version":"3.54.0"},"reference-count":62,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Minimally invasive anterior and lateral approaches to the lumbar spine are increasingly used to treat and reduce grade I spondylolisthesis, but concerns still exist for their usage in the management of higher-grade lesions. The authors report their experience with this strategy for grade II spondylolisthesis in a single-surgeon case series and provide early clinical and radiographic outcomes.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A retrospective review of a single surgeon\u2019s cases between 2012 and 2016 identified all patients with a Meyerding grade II lumbar spondylolisthesis who underwent minimally invasive lateral lumbar interbody fusion (LLIF) or anterior lumbar interbody fusion (ALIF) targeting the slipped level. Demographic, clinical, and radiographic data were collected and analyzed. Changes in radiographic measurements, Oswestry Disability Index (ODI), and visual analog scale (VAS) scores were compared using the paired t-test and Wilcoxon signed rank test for continuous and ordinal variables, respectively.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The average operative time was 199.1 minutes (with 60.6 ml of estimated blood loss) for LLIFs and 282.1 minutes (with 106.3 ml of estimated blood loss), for ALIFs. Three LLIF patients had transient unilateral anterior thigh numbness during the 1st week after surgery, and 1 ALIF patient had transient dorsiflexion weakness, which was resolved at postoperative week 1. The mean follow-up time was 17.6 months (SD 12.5 months) for LLIF patients and 10 months (SD 3.1 months) for ALIF patients. Complete reduction of the spondylolisthesis was achieved in 12 LLIF patients (75.0%) and 7 ALIF patients (87.5%). Across both procedures, there was an increase in both the segmental lordosis (LLIF 5.6\u00b0, p = 0.002; ALIF 15.0\u00b0, p = 0.002) and overall lumbar lordosis (LLIF 2.9\u00b0, p = 0.151; ALIF 5.1\u00b0, p = 0.006) after surgery. Statistically significant decreases in the mean VAS and the mean ODI measurements were seen in both treatment groups. The VAS and ODI scores fell by a mean value of 3.9 (p = 0.002) and 19.8 (p = 0.001), respectively, for LLIF patients and 3.8 (p = 0.02) and 21.0 (p = 0.03), respectively, for ALIF patients at last follow-up.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Early clinical and radiographic results from using minimally invasive LLIF and ALIF approaches to treat grade II spondylolisthesis appear to be good, with low operative blood loss and no neurological deficits. Complete reduction of the spondylolisthesis is frequently possible with a statistically significant reduction in pain scores.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2017.10.focus17574","type":"journal-article","created":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T03:36:42Z","timestamp":1514777802000},"page":"E4","source":"Crossref","is-referenced-by-count":31,"title":["Minimally invasive anterior and lateral transpsoas approaches for closed reduction of grade II spondylolisthesis: initial clinical and radiographic experience"],"prefix":"10.3171","volume":"44","author":[{"given":"David S.","family":"Xu","sequence":"first","affiliation":[{"name":"Division of Spinal Disorders, Department of Neurological Surgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konrad","family":"Bach","sequence":"additional","affiliation":[{"name":"Division of Spine, Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan S.","family":"Uribe","sequence":"additional","affiliation":[{"name":"Division of Spinal Disorders, Department of Neurological Surgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg Spine","first-page":"289","article-title":"Analysis of lumbar plexopathies and nerve injury after lateral retroperitoneal transpsoas approach: diagnostic standardization","volume":"18","author":"Ahmadian A","year":"2013","unstructured":"Ahmadian A, Deukmedjian AR, Abel N, Dakwar E, Uribe JS: Analysis of lumbar plexopathies and nerve injury after lateral retroperitoneal transpsoas approach: diagnostic standardization. J Neurosurg Spine 18:289\u2013297, 2013"},{"key":"b2","series-title":"J Neurosurg Spine","first-page":"314","article-title":"Minimally invasive lateral retroperitoneal transpsoas interbody fusion for L4\u20135 spondylolisthesis: clinical outcomes","volume":"19","author":"Ahmadian A","year":"2013","unstructured":"Ahmadian A, Verma S, Mundis GM Jr, Oskouian RJ Jr, Smith DA, Uribe JS: Minimally invasive lateral retroperitoneal transpsoas interbody fusion for L4\u20135 spondylolisthesis: clinical outcomes. J Neurosurg Spine 19:314\u2013320, 2013"},{"key":"b3","series-title":"J Neurosurg Spine","first-page":"139","article-title":"An anatomical study of the lumbosacral plexus as related to the minimally invasive transpsoas approach to the lumbar spine","volume":"10","author":"Benglis DM","year":"2009","unstructured":"Benglis DM, Vanni S, Levi AD: An anatomical study of the lumbosacral plexus as related to the minimally invasive transpsoas approach to the lumbar spine. J Neurosurg Spine 10:139\u2013144, 2009"},{"key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"1681","article-title":"Endoscopic lateral transpsoas approach to the lumbar spine","volume":"29","author":"Bergey DL","year":"2004","unstructured":"Bergey DL, Villavicencio AT, Goldstein T, Regan JJ: Endoscopic lateral transpsoas approach to the lumbar spine. Spine (Phila Pa 1976) 29:1681\u20131688, 2004"},{"key":"b5","series-title":"Spine (Phila Pa 1976)","first-page":"1655","article-title":"Treatment of severe spondylolisthesis by reduction and pedicular fixation. A 4\u20136-year follow-up study","volume":"18","author":"Boos N","year":"1993","unstructured":"Boos N, Marchesi D, Zuber K, Aebi M: Treatment of severe spondylolisthesis by reduction and pedicular fixation. A 4\u20136-year follow-up study. Spine (Phila Pa 1976) 18:1655\u20131661, 1993"},{"key":"b6","series-title":"Spine (Phila Pa 1976)","first-page":"1410","article-title":"Anterior fresh frozen structural allografts in the thoracic and lumbar spine. Do they work if combined with posterior fusion and instrumentation in adult patients with kyphosis or anterior column defects?","volume":"20","author":"Bridwell KH","year":"1995","unstructured":"Bridwell KH, Lenke LG, McEnery KW, Baldus C, Blanke K: Anterior fresh frozen structural allografts in the thoracic and lumbar spine. Do they work if combined with posterior fusion and instrumentation in adult patients with kyphosis or anterior column defects? Spine (Phila Pa 1976) 20:1410\u20131418, 1995"},{"key":"b7","series-title":"Clin Orthop Surg","first-page":"49","article-title":"MRI measurement of neuroforaminal dimension at the index and supradjacent levels after anterior lumbar interbody fusion: a prospective study","volume":"5","author":"Cho W","year":"2013","unstructured":"Cho W, Sokolowski MJ, Mehbod AA, Denis F, Garvey TA, Perl J, : MRI measurement of neuroforaminal dimension at the index and supradjacent levels after anterior lumbar interbody fusion: a prospective study. Clin Orthop Surg 5:49\u201354, 2013"},{"key":"b8","series-title":"Spine J [epub ahead of print]","article-title":"Transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) in lumbar spondylolisthesis: a systematic review and meta-analysis","author":"de Kunder SL","year":"2017","unstructured":"de Kunder SL, van Kuijk SMJ, Rijkers K, Caelers IJMH, van Hemert WLW, de Bie RA, : Transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) in lumbar spondylolisthesis: a systematic review and meta-analysis. Spine J [epub ahead of print], 2017"},{"issue":"Suppl 3","key":"b9","series-title":"Surg Neurol Int","first-page":"S96","article-title":"More nerve root injuries occur with minimally invasive lumbar surgery: Let\u2019s tell someone","volume":"7","author":"Epstein NE","year":"2016","unstructured":"Epstein NE: More nerve root injuries occur with minimally invasive lumbar surgery: Let\u2019s tell someone. Surg Neurol Int 7 (Suppl 3):S96\u2013S101, 2016"},{"key":"b10","series-title":"J Spinal Disord Tech","first-page":"321","article-title":"Radiographic and clinical outcomes after instrumented reduction and transforaminal lumbar interbody fusion of mid and high-grade isthmic spondylolisthesis","volume":"22","author":"Goyal N","year":"2009","unstructured":"Goyal N, Wimberley DW, Hyatt A, Zeiller S, Vaccaro AR, Hilibrand AS, : Radiographic and clinical outcomes after instrumented reduction and transforaminal lumbar interbody fusion of mid and high-grade isthmic spondylolisthesis. 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J Clin Neurosci 45:218\u2013222, 2017"},{"key":"b13","series-title":"Neurosurgery","first-page":"109","article-title":"Short-term complications associated with surgery for high-grade spondylolisthesis in adults and pediatric patients: a report from the Scoliosis Research Society Morbidity and Mortality database","volume":"71","author":"Kasliwal MK","year":"2012","unstructured":"Kasliwal MK, Smith JS, Shaffrey CI, Saulle D, Lenke LG, Polly DW Jr, : Short-term complications associated with surgery for high-grade spondylolisthesis in adults and pediatric patients: a report from the Scoliosis Research Society Morbidity and Mortality database. 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Eur Spine J 17:1170\u20131176, 2008"},{"key":"b16","series-title":"Spine (Phila Pa 1976)","first-page":"1693","article-title":"Clinical and radiologic 2\u20134-year results of transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2","volume":"31","author":"Lauber S","year":"2006","unstructured":"Lauber S, Schulte TL, Liljenqvist U, Halm H, Hackenberg L: Clinical and radiologic 2\u20134-year results of transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2. 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Neurosurg Focus 43(2):E12, 2017"},{"key":"b28","series-title":"Spine J","first-page":"817","article-title":"Indirect foraminal decompression after anterior lumbar interbody fusion: a prospective radiographic study using a new pedicle-to-pedicle technique","volume":"15","author":"Rao PJ","year":"2015","unstructured":"Rao PJ, Maharaj MM, Phan K, Lakshan Abeygunasekara M, Mobbs RJ: Indirect foraminal decompression after anterior lumbar interbody fusion: a prospective radiographic study using a new pedicle-to-pedicle technique. Spine J 15:817\u2013824, 2015"},{"issue":"36","key":"b29","series-title":"Spine (Phila Pa 1976)","first-page":"26","article-title":"Intraoperative and early postoperative complications in extreme lateral interbody fusion: an analysis of 600 cases","author":"Rodgers WB","year":"2011","unstructured":"Rodgers WB, Gerber EJ, Patterson J: Intraoperative and early postoperative complications in extreme lateral interbody fusion: an analysis of 600 cases. 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J Neurosurg Spine 12:694\u2013699, 2010"},{"key":"b1","series-title":"J Neurosurg Spine","first-page":"289","article-title":"Analysis of lumbar plexopathies and nerve injury after lateral retroperitoneal transpsoas approach: diagnostic standardization","volume":"18","author":"Ahmadian A","year":"2013","unstructured":"Ahmadian A, Deukmedjian AR, Abel N, Dakwar E, Uribe JS: Analysis of lumbar plexopathies and nerve injury after lateral retroperitoneal transpsoas approach: diagnostic standardization. J Neurosurg Spine 18:289\u2013297, 2013"},{"key":"b2","series-title":"J Neurosurg Spine","first-page":"314","article-title":"Minimally invasive lateral retroperitoneal transpsoas interbody fusion for L4\u20135 spondylolisthesis: clinical outcomes","volume":"19","author":"Ahmadian A","year":"2013","unstructured":"Ahmadian A, Verma S, Mundis GM Jr, Oskouian RJ Jr, Smith DA, Uribe JS: Minimally invasive lateral retroperitoneal transpsoas interbody fusion for L4\u20135 spondylolisthesis: clinical outcomes. J Neurosurg Spine 19:314\u2013320, 2013"},{"key":"b3","series-title":"J Neurosurg Spine","first-page":"139","article-title":"An anatomical study of the lumbosacral plexus as related to the minimally invasive transpsoas approach to the lumbar spine","volume":"10","author":"Benglis DM","year":"2009","unstructured":"Benglis DM, Vanni S, Levi AD: An anatomical study of the lumbosacral plexus as related to the minimally invasive transpsoas approach to the lumbar spine. J Neurosurg Spine 10:139\u2013144, 2009"},{"key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"1681","article-title":"Endoscopic lateral transpsoas approach to the lumbar spine","volume":"29","author":"Bergey DL","year":"2004","unstructured":"Bergey DL, Villavicencio AT, Goldstein T, Regan JJ: Endoscopic lateral transpsoas approach to the lumbar spine. Spine (Phila Pa 1976) 29:1681\u20131688, 2004"},{"key":"b5","series-title":"Spine (Phila Pa 1976)","first-page":"1655","article-title":"Treatment of severe spondylolisthesis by reduction and pedicular fixation. A 4\u20136-year follow-up study","volume":"18","author":"Boos N","year":"1993","unstructured":"Boos N, Marchesi D, Zuber K, Aebi M: Treatment of severe spondylolisthesis by reduction and pedicular fixation. A 4\u20136-year follow-up study. 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Surg Neurol Int 7 (Suppl 3):S96\u2013S101, 2016"},{"key":"b10","series-title":"J Spinal Disord Tech","first-page":"321","article-title":"Radiographic and clinical outcomes after instrumented reduction and transforaminal lumbar interbody fusion of mid and high-grade isthmic spondylolisthesis","volume":"22","author":"Goyal N","year":"2009","unstructured":"Goyal N, Wimberley DW, Hyatt A, Zeiller S, Vaccaro AR, Hilibrand AS, : Radiographic and clinical outcomes after instrumented reduction and transforaminal lumbar interbody fusion of mid and high-grade isthmic spondylolisthesis. J Spinal Disord Tech 22:321\u2013327, 2009"},{"key":"b11","series-title":"Eur Spine J","first-page":"557","article-title":"An MRI study of psoas major and abdominal large vessels with respect to the X\/DLIF approach","volume":"20","author":"Hu WK","year":"2011","unstructured":"Hu WK, He SS, Zhang SC, Liu YB, Li M, Hou TS, : An MRI study of psoas major and abdominal large vessels with respect to the X\/DLIF approach. Eur Spine J 20:557\u2013562, 2011"},{"key":"b12","series-title":"J Clin Neurosci","first-page":"218","article-title":"Indirect decompression and reduction of lumbar spondylolisthesis does not result in higher rates of immediate and long term complications","volume":"45","author":"Januszewski J","year":"2017","unstructured":"Januszewski J, Beckman JM, Bach K, Vivas AC, Uribe JS: Indirect decompression and reduction of lumbar spondylolisthesis does not result in higher rates of immediate and long term complications. J Clin Neurosci 45:218\u2013222, 2017"},{"key":"b13","series-title":"Neurosurgery","first-page":"109","article-title":"Short-term complications associated with surgery for high-grade spondylolisthesis in adults and pediatric patients: a report from the Scoliosis Research Society Morbidity and Mortality database","volume":"71","author":"Kasliwal MK","year":"2012","unstructured":"Kasliwal MK, Smith JS, Shaffrey CI, Saulle D, Lenke LG, Polly DW Jr, : Short-term complications associated with surgery for high-grade spondylolisthesis in adults and pediatric patients: a report from the Scoliosis Research Society Morbidity and Mortality database. Neurosurgery 71:109\u2013116, 2012"},{"issue":"Suppl","key":"b14","series-title":"J Spinal Disord Tech","first-page":"S30","article-title":"A critical analysis of the literature regarding surgical approach and outcome for adult low-grade isthmic spondylolisthesis","volume":"18","author":"Kwon BK","year":"2005","unstructured":"Kwon BK, Hilibrand AS, Malloy K, Savas PE, Silva MT, Albert TJ, : A critical analysis of the literature regarding surgical approach and outcome for adult low-grade isthmic spondylolisthesis. J Spinal Disord Tech 18 Suppl:S30\u2013S40, 2005"},{"key":"b15","series-title":"Eur Spine J","first-page":"1170","article-title":"Spino-pelvic alignment after surgical correction for developmental spondylolisthesis","volume":"17","author":"Labelle H","year":"2008","unstructured":"Labelle H, Roussouly P, Chopin D, Berthonnaud E, Hresko T, O\u2019Brien M: Spino-pelvic alignment after surgical correction for developmental spondylolisthesis. 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