• Ryota Kimura, Mitsunori Yoshimoto, Naohisa Miyakoshi, Michio Hongo, Yuji Kasukawa, Takashi Kobayashi, Kazuma Kikuchi, Koichiro Okuyama, Tadato Kido, Ryosuke Hirota, Shuto Hamada, Mitsuho Chiba, Eiji Abe, Toshihiko Yamashita, and Yoichi Shimada.
• Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita.
• Clin Spine Surg. 2019 Oct 1; 32 (8): E380-E385.

Study DesignRetrospective analysis of prospectively collected observational multicenter data.ObjectiveTo compare the clinical results and rates of revision surgery after posterior lumbar interbody fusion (PLIF) and microendoscopic muscle-preserving interlaminar decompression (ME-MILD) in patients with single-level, mild degenerative lumbar spondylolisthesis (DLS) and follow-up of at least 5 years.Summary Of Background DataSurgery for symptomatic DLS remains controversial. Evaluating long-term results may reveal problems such as adjacent segmental diseases of the PLIF and decreased quality of life because of slippage and restenosis of the ME-MILD.MethodsWe enrolled 116 patients who underwent PLIF (79 patients) or ME-MILD (37 patients). Operative times, blood losses, surgical complications, Short-Form 36 (SF-36), Japanese Orthopedic Association (JOA) score, the JOA Back Pain Questionnaire (JOABPEQ), visual analog scales (VAS), and Zurich Claudication Questionnaire (ZCQ) were evaluated.ResultsPLIF was observed to require significantly longer operative times and entailed greater operative blood losses than did ME-MILD (151.1 vs. 119.9 min; 202.2 vs. 6.4 mL, respectively). Surgery-related complications were identified in 3 cases in the PLIF group and 2 cases in the ME-MILD group. Seventy-eight patients (50 and 28 patients in the PLIF and ME-MILD groups, respectively) were successfully followed-up for >5 years. The follow-up rate was 67.2%. No significant differences between the groups were found in terms of preoperative and postoperative JOA scores, postoperative JOABPEQ, VAS, or ZCQ. Significant improvements in JOA scores were observed in both groups. Significant improvements in the SF-36 were observed in all subscales except in role physical, general health, vitality, and mental health in the ME-MILD group. Revision surgical procedures were performed in 2 patients in the ME-MILD group and 4 patients in the PLIF group.ConclusionsPLIF and ME-MILD resulted in equivalent improvements in SF-36 and JOA scores. There were no differences in revision surgery rates among patients with single-level, mild DLS.Level Of EvidenceLevel III-a retrospective analysis.

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