• Daniel Wolfson, Julia Mueller, Bradley Hunt, Ryan Kelly, Jacob Mazza, Bledi Brahimaj, John E O'Toole, Harel Deutsch, Richard G Fessler, and FontesRicardo B VRBVDepartment of Neurological Surgery, Rush University Medical Center, Chicago, Illinois, USA..
• Department of Neurological Surgery, Rush University Medical Center, Chicago, Illinois, USA. Electronic address: daniel_i_wolfson@rush.edu.
• World Neurosurg. 2024 Jun 1; 186: e577e583e577-e583.

Background And ObjectivesStudies have demonstrated increased risk of adjacent segment disease (ASD) after open fusion with adjacent-level laminectomy, with rates ranging from 16%-47%, potentially related to disruption of the posterior ligamentous complex. Minimally invasive surgical (MIS) approaches may offer a more durable result. We report institutional outcomes of simultaneous MIS transforaminal lumbar interbody fusion (MISTLIF) and adjacent-level laminectomy for patients with low grade spondylolisthesis and ASD.MethodsRetrospective analysis was performed on patients who underwent MISTLIF with adjacent level laminectomy to treat grade I-II spondylolisthesis with adjacent stenosis at a single institution from 2007-2022.ResultsA total of 34 patients met criteria, with mean follow-up of 23.1 months. In total, 37 levels were fused and 45 laminectomies performed. In this group, 21 patients received a single level laminectomy and single-level MISTLIF, 10 patients received a 2-level laminectomy and single-level MISTLIF, 2 patients received a single-level laminectomy and 2-level MISTLIF, and 1 patient received a 2-level laminectomy and 2-level MISTLIF. Three (8.8%) patients experienced clinically significant postoperative ASD requiring reoperation. Three other patients required reoperation for other reasons. Multiple logistic regression did not reveal any association between development of ASD and surgical covariates.ConclusionMISTLIF with adjacent-level laminectomy demonstrated a favorable safety profile with rates of postoperative ASD lower than published rates after open fusion and on par with the published rates of ASD from MISTLIF alone. Future prospective studies may better elucidate the durability of adjacent-level laminectomies when performed alongside MISTLIF, but retrospective data suggests it is safe and durable.Copyright © 2024 Elsevier Inc. All rights reserved.

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