Abstract: This study investigated the efficacy of transforaminal lumbar interbody fusion (TLIF) with different approaches in patients with isthmic lumbar spondylolisthesis and the differences in the effects of sagittal imaging parameters. A total of 102 patients with isthmic spondylolisthesis were selected and randomly divided into a minimally invasive group and an open group, with 51 cases in each group. The minimally invasive group underwent Wiltse approach and minimally invasive TLIF under the MAST Quadrant channel, and the open group underwent traditional TLIF. The surgical conditions and excellent and good rates of treatment in the two groups were calculated. X-ray was used to determine the lumbar lordosis angle (LL), lumbosacral angle (LSA), distance between L1 plumb line and S1 (LASD), pelvic tilt angle (PT), sacral tilt angle (SS), pelvic incidence angle (PI), slip angle (SA) before and after surgery. The operation time, hospital stay, and postoperative bed rest time in the minimally invasive group were shorter than those in the open group, and the incision length, intraoperative blood loss, and postoperative drainage volume were lower than those in the open group (P<0.05). There was no significant difference in the excellent and good rates between the two groups (P>0.05). 6 months after operation, LL increased and SA decreased in both groups compared with preoperative (P<0.05), but there was no significant difference between the two groups (P>0.05). Both TLIF approaches can improve lumbar-pelvic sagittal imaging parameters with comparable efficacy, but the Wiltse approach and MAST Quadrant canal are more minimally invasive.

Key words: transforaminal lumbar interbody fusion, approach, isthmic spondylolisthesis, sagittal imaging parameters