Application of minimally invasive decompression interventions for the surgical treatment of degenerative lumbar spondylolysthesis

Objective. To evaluate the effectiveness of surgical treatment of patients with degenerative lumbar spondylolisthesis, operated using minimally invasive bilateral decompression from a unilateral approach.

Materials and methods. The long-term results of minimally invasive bilateral decompression in patients with lumbar spondylolisthesis were studied. The dynamics of postoperative instability were assessed using various surgical treatment methods for dorsopathies.

Results. Minimally invasive decompression procedures performed through a unilateral surgical approach (the Over-the-top technology) for degenerative lumbar spondylolisthesis are characterized by a lower incidence of late postoperative instability compared to extensive bone resections without stabilization. A study of pain intensity and patient quality of life revealed a statistically significant difference (p < 0.05) between bilateral decompressions through a unilateral approach and classic laminectomy. The use of this minimally invasive technique reduces surgical time and intraoperative blood loss.

Conclusion. The Over-the-top technology, coupled with new approaches to preoperative planning and virtual support, has demonstrated its effectiveness as a surgical treatment for lumbar spondylolisthesis. Minimally invasive bilateral decompressions through a unilateral approach resulted in lower rates of postoperative instability (p = 0.044) compared to traditional laminectomy. Furthermore, in terms of patient quality of life and pain intensity in the long-term period, the technique is comparable to decompression and stabilization procedures (p > 0.05). The data obtained during the study confirm the feasibility of using the Over-the-top technology as a low-trauma, safe, cost-effective, and clinically effective alternative to extensive decompression procedures supplemented by spinal fusion.

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