{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T01:05:40Z","timestamp":1779843940911,"version":"3.53.1"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"21","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,5,25]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Patients with lumbar isthmic spondylolisthesis (LIS) and spinal stenosis (SS) are commonly treated with decompression and fusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 78-year-old male presented with radicular pain, numbness in the posterolateral aspect of both legs, and intermittent claudication. No obvious neurological abnormality was detected. Lumbar radiography and CT showed mild scoliosis and almost grade 2 L4\u20135 LIS with instability. MRI revealed severe SS at L3\u20135 and bilateral intervertebral foramen stenosis at L4\u20135. Combined extreme lateral interbody fusion (XLIF) with percutaneous pedicle screw (PPS) fixation at L4\u20135 and full endoscopic laminectomy (FEL) at L3\u20135 were performed under general anesthesia. Postoperative MRI and CT revealed an expanded lumbar canal at L3\u20135 and decompression of the bilateral L4 and L5 nerve roots. The patient\u2019s symptoms resolved postoperatively, and the patient was discharged without perioperative complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>The combined XLIF with PPS and FEL technique may represent a minimally invasive and effective treatment for patients with SS due to LIS.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE251027\">https:\/\/thejns.org\/doi\/10.3171\/CASE251027<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case251027","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T14:52:32Z","timestamp":1779288752000},"source":"Crossref","is-referenced-by-count":0,"title":["Minimally invasive lumbar spine surgery combining extreme lateral internal fusion, percutaneous pedicle screw fixation, and full endoscopic laminectomy for lumbar isthmic spondylolisthesis with spinal stenosis: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"given":"Yoshihiko","family":"Ioroi","sequence":"first","affiliation":[{"name":"Department of Spinal Neurosurgery, Kyoto Katsura Hospital, Kyoto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7170-4564","authenticated-orcid":true,"given":"Toshinari","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery, Kyoto Katsura Hospital, Kyoto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6764-3284","authenticated-orcid":true,"given":"Yoshinori","family":"Maki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hikone Chuo Hospital, Hikone, Shiga, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motohiro","family":"Takayama","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery, Kyoto Katsura Hospital, Kyoto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamaki","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery, Kyoto Katsura Hospital, Kyoto"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"22","key":"bib1","series-title":"N Engl J Med","first-page":"2257","article-title":"Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis","volume":"356","author":"Weinstein","year":"2007","unstructured":"Weinstein JNLurie JDTosteson TDSurgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. N Engl J Med. 2007;356(22):2257-2270. doi:10.1056\/NEJMoa070302"},{"issue":"14","key":"bib2","series-title":"Spine (Phila Pa 1976)","first-page":"1329","article-title":"Surgical versus nonoperative treatment for lumbar spinal stenosis four-year results of the Spine Patient Outcomes Research Trial","volume":"35","author":"Weinstein","year":"2010","unstructured":"Weinstein JNTosteson TDLurie JDSurgical versus nonoperative treatment for lumbar spinal stenosis four-year results of the Spine Patient Outcomes Research Trial. Spine (Phila Pa 1976). 2010;35(14):1329-1338. doi:10.1097\/BRS.0b013e3181e0f04d"},{"issue":"19","key":"bib3","series-title":"Spine (Phila Pa 1976)","first-page":"1584","article-title":"National trends in the use of fusion techniques to treat degenerative spondylolisthesis","volume":"39","author":"Kepler","year":"2014","unstructured":"Kepler CKVaccaro ARHilibrand ASNational trends in the use of fusion techniques to treat degenerative spondylolisthesis. Spine (Phila Pa 1976). 2014;39(19):1584-1589. doi:10.1097\/BRS.0000000000000486"},{"key":"bib4","series-title":"World Neurosurg","first-page":"622","article-title":"Evolution of minimally invasive lumbar spine surgery","volume":"140","author":"Momin","year":"2020","unstructured":"Momin AASteinmetz MP.Evolution of minimally invasive lumbar spine surgery. World Neurosurg. 2020;140:622-626. doi:10.1016\/j.wneu.2020.05.071"},{"issue":"1","key":"bib5","series-title":"Neurosurg Clin N Am","first-page":"25","article-title":"Endoscopic lumbar decompression","volume":"31","author":"Ruetten","year":"2020","unstructured":"Ruetten SKomp M.Endoscopic lumbar decompression. Neurosurg Clin N Am. 2020;31(1):25-32. doi:10.1016\/j.nec.2019.08.003"},{"issue":"1","key":"bib6","series-title":"J Spine Surg","first-page":"2","article-title":"Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF\/ATP, LLIF and ALIF","volume":"1","author":"Mobbs","year":"2015","unstructured":"Mobbs RJPhan KMalham GSeex KRao PJ.Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF\/ATP, LLIF and ALIF. 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World Neurosurg. 2020;140:622-626. doi:10.1016\/j.wneu.2020.05.071"},{"issue":"1","key":"bib5","series-title":"Neurosurg Clin N Am","first-page":"25","article-title":"Endoscopic lumbar decompression","volume":"31","author":"Ruetten","year":"2020","unstructured":"Ruetten SKomp M.Endoscopic lumbar decompression. Neurosurg Clin N Am. 2020;31(1):25-32. doi:10.1016\/j.nec.2019.08.003"},{"issue":"1","key":"bib6","series-title":"J Spine Surg","first-page":"2","article-title":"Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF\/ATP, LLIF and ALIF","volume":"1","author":"Mobbs","year":"2015","unstructured":"Mobbs RJPhan KMalham GSeex KRao PJ.Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF\/ATP, LLIF and ALIF. J Spine Surg. 2015;1(1):2-18. doi:10.3978\/j.issn.2414-469X.2015.10.05"},{"issue":"4","key":"bib7","series-title":"Spine J","first-page":"435","article-title":"Extreme lateral interbody fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion","volume":"6","author":"Ozgur","year":"2006","unstructured":"Ozgur BMAryan HEPimenta LTaylor WR.Extreme lateral interbody fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion. Spine J. 2006;6(4):435-443. doi:10.1016\/j.spinee.2005.08.012"},{"issue":"suppl 3","key":"bib8","series-title":"Surg Neurol Int","first-page":"S198","article-title":"The lateral transpsoas approach to the lumbar and thoracic spine: a review","volume":"3","author":"Arnold","year":"2012","unstructured":"Arnold PMAnderson KKMcGuire RA.The lateral transpsoas approach to the lumbar and thoracic spine: a review. 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Pain Physician. 2015;18(1):61-70."},{"issue":"5","key":"bib11","series-title":"J Neurosurg Spine","first-page":"476","article-title":"Surgical treatment for lumbar lateral recess stenosis with the full-endoscopic interlaminar approach versus conventional microsurgical technique: a prospective, randomized, controlled study","volume":"10","author":"Ruetten","year":"2009","unstructured":"Ruetten SKomp MMerk HGodolias G.Surgical treatment for lumbar lateral recess stenosis with the full-endoscopic interlaminar approach versus conventional microsurgical technique: a prospective, randomized, controlled study. 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