Comparative analysis of the results of minimally invasive and traditional surgical treatment of patients with lumbosacral spondylolisthesis

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Abstract

Background. Minimally invasive surgery (MIS) has been increasingly utilized as an alternative to open surgery (OPEN) for lumbo-sacral spondylolisthesis treatment. However, comparative analyses of outcomes remain limited.

Aims — to compare perioperative and functional outcomes between MIS and OPEN in patients with lumbar spondylolisthesis.

Methods. A retrospective cohort study of 224 patients (2018–2024) was conducted. Patients were divided into MIS (n = 120) and OPEN (n = 104) groups. Outcomes analyzed included surgical duration, blood loss, hospital stay, functional recovery (Oswestry Disability Index, ODI), pain reduction (Visual Analog Scale, VAS), and complications. Statistical analysis was performed using the Wilcoxon rank-sum test (p < 0.05 considered significant).

Results. MIS demonstrated shorter operative time (145 min vs. 200 min, p < 0.001), reduced blood loss (140 mL vs. 400 mL, p < 0.001), and shorter hospital stay (4 vs. 9 days, p < 0.001). Functional recovery and pain relief were also superior in MIS, with fewer complications.

Conclusions. MIS is associated with faster recovery, lower complication rates, and improved functional outcomes compared to OPEN. These findings support the increased adoption of MIS in lumbar spondylolisthesis treatment.

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About the authors

Nikolay A. Konovalov

N.N. Burdenko National Medical Research Center of Neurosurgery

Email: rekatut@yandex.ru
ORCID iD: 0000-0003-0824-1848
SPIN-code: 9436-3719

MD, PhD, Professor, Corresponding Member of the RAS

Russian Federation, Moscow

Dmitriy Yu. Usachev

N.N. Burdenko National Medical Research Center of Neurosurgery

Email: rekatut@yandex.ru
ORCID iD: 0000-0002-9811-9442
SPIN-code: 6618-0420

MD, PhD, Professor, Academician of the RAS

Russian Federation, Moscow

Nikita O. Ilyinskiy

N.N. Burdenko National Medical Research Center of Neurosurgery

Email: rekatut@yandex.ru
ORCID iD: 0009-0005-4320-741X

Resident

Russian Federation, Moscow

Evgeniy S. Brinyuk

N.N. Burdenko National Medical Research Center of Neurosurgery

Email: rekatut@yandex.ru
ORCID iD: 0000-0001-6184-7481
SPIN-code: 3381-3193

MD, PhD

Russian Federation, Moscow

Bakhromkhon A. Zakirov

N.N. Burdenko National Medical Research Center of Neurosurgery

Email: rekatut@yandex.ru
ORCID iD: 0000-0002-8782-850X
SPIN-code: 5240-7555

MD, PhD

Russian Federation, Moscow

Sergey V. Ivanov

N.N. Burdenko National Medical Research Center of Neurosurgery

Author for correspondence.
Email: rekatut@yandex.ru
ORCID iD: 0009-0007-4094-6959
SPIN-code: 1476-1068

PhD Student

Russian Federation, 16 4th Tverskaya-Yamskaya str., 125047, Moscow

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Supplementary files

Supplementary Files
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1. JATS XML
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2. Fig. 1. Patient's position

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3. Fig. 2. Intraoperative spiral computed tomograph SOMATOM Definition Edge (Siemens, Germany)

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4. Fig. 3. StealthStation S8 surgical navigation system (Medtronic, USA)

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5. Неозаглавлен

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6. Fig. 4. Installation of the transpedicular screws: A — view of the surgeon's actions; B — intraoperative control of the position and size of the transpedicular screws using the navigation system

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7. Fig. 5. Intraoperative CT control with 3D reconstruction of the correct placement of the interbody implant and transpedicular screws: A — sagittal projection; B, C — axial projection of transpedicular screws in the bodies of the L4 (B) and L5 (C) vertebrae

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8. Fig. 6. Control CT scans of the lumbar spine 3, 6, and 12 months after surgery

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