Objective To compare the early clinical outcomes,screw placement accuracy and supradjacent facet joint vi-olation between O-arm navigated minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)and TLIF for the treat-ment of lumbar spondylolisthesis.Methods We retrospectively reviewed a cohort of low-grade single level lumbar spondylolis-thesis patients who have received O-arm navigated MIS-TLIF or open-TLIF treatment from May 2018 to July 2023.There were 60 patients in MIS-TLIF group including 24 males and 36 females,and the average age was 41.0±13.9 years(18-73 years).There were 120 patients in open-TLIF group including 43 males and 77 females,and the average age was 41.6±12.6 years(18-69 years).The demographic and perioperative data of patients were recorded.Preoperative lumbar CT and MRI were evaluated to assess the grade of adjacent facet joint degeneration and fatty infiltration in the lumbar paraspinal muscles.The slip parameters were mea-sured by lateral X-ray films before and after operation,and the screw placement accuracy and supradjacent facet joint violation were evaluated by postoperative CT.Patient reported outcomes,including Oswestry disability index(ODI)and visual analogue scale(VAS)were collected preoperatively and 3 months postoperatively.Results There was no significant difference in demo-graphic data,adjacent facet joint degeneration,fatty infiltration of lumbar paraspinal muscles and preoperative ODI and VAS scores between the two groups(P＞0.05).The operation time in MIS-TLIF group(223.3±23.0 min)was significantly longer than that in open-TLIF group(187.0±30.5 min,t=8.130,P＜0.001),while the intraoperative blood loss(150.7±56.8 mlvs.392.8±161.5 ml,t=-11.253,P＜0.001),postoperative drainage(60.4±19.8 ml vs.215.2±57.2 ml,t=-20.328,P＜0.001)and postoperative hospi-tal stay(4.5±1.7 d vs.8.4±2.5 d,t=-10.769,P＜0.001)in MIS-TLIF group were significantly less.The 3-month postoperative VAS back pain of the MIS-TLIF group(2.0±1.7)was lower than the open-TLIF group(3.2±2.0,t=-3.956,P＜0.001).Both groups had similar slip reduction results(P＞0.05).The accuracy of the pedicle screw placement in MIS-TLIF group(98.8％)was better than open-TLIF group(92.3％,P＜0.001).The incidence of supradjacent facet joint violation in the MIS-TLIF group was lower than open-TLIF group(27.5％vs.51.7％,x2=19.111,P＜0.001).There were no notable surgical complications in MIS-TLIF group except tem-porary submuscular hematoma in one patient.In open-TLIF group,dural tear occurred in three patients intraoperatively,one pa-tient experienced transient L5 nerve root palsy after surgery and one patient had wound superficial tissue infection.All the compli-cations were successfully treated with conservative measures.Conclusion O-arm navigated MIS-TLIF had better short-term clin-ical effect and higher accuracy of pedicle screw placement in treating lumbar spondylolisthesis.
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