AUTHOR=Chen Zhi-da , Wu Song-song , Jiang Yuan-jie , Liu Hui , Huang Zhuan-zhi , Cai Tao-yi , Lin Bin 

TITLE=Single-position OLIF combined with percutaneous posterior fixation under O-arm navigation for the treatment of grade II lumbar spondylolisthesis: clinical and radiologic outcomes

JOURNAL=Frontiers in Surgery

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2025.1676460

DOI=10.3389/fsurg.2025.1676460

ISSN=2296-875X

ABSTRACT=Introduction and aimGrade II lumbar spondylolisthesis is frequently accompanied by segmental instability, intervertebral disc degeneration, and nerve root compression. When conservative management fails, surgery is generally warranted. Therefore, we conducted a retrospective study to evaluate the clinical and radiologic outcomes of single-position OLIF combined with percutaneous posterior fixation under O-arm navigation for the treatment of Grade II lumbar spondylolisthesis.Materials and methodsA retrospective analysis was conducted on 87 patients with Grade II lumbar spondylolisthesis who underwent single-position OLIF combined with percutaneous posterior fixation under O-arm navigation. The affected segments were as follows: 17 cases at L2, 26 cases at L3, and 44 cases at L4. Data were collected on operation duration, blood loss, hospital stay, radiological and clinical outcomes (VAS, ODI, SF-36, intervertebral disc height, slippage rate, lumbar lordosis angle, cross-sectional area, and sagittal diameter), Bridwell classification, and complications.ResultsThe mean operation duration was 118.7 ± 22.4 min, with an average blood loss of 83.6 ± 27.4 ml. All patients had regular follow up with an average duration of 29.5 ± 9.2 months. The VAS scores, ODI, and SF-36 at 3 months postoperatively and final follow-up showed significant improvement compared to preoperative scores (P < 0.05). The IDH, SR, and LLA were significantly improved at 3 days, 12 months, and at the final follow-up compared to preoperative values (All P < 0.01). Mean cross-sectional area improved significantly from 87.40 ± 29.59 mm2 preoperatively to 132.42 ± 33.53 mm2 at 12 months follow-up (P < 0.001). The mean sagittal diameter at 12 months follow-up 9.23 ± 2.87 mm showed statistically significant difference compared to preoperative measurements 5.25 ± 2.67 mm. 94.3% (82/87) of patients achieving Bridwell Grade I bone fusion. A total of 348 pedicle screws were implanted with an overall accuracy rate of approximately 98.9%. Complications were minimal, with 3 cases of psoas weakness that resolved to normal muscle strength within 2 weeks.ConclusionsIt offers significant minimal invasiveness, accuracy in screw placement, and sustained reconstruction of lumbar sagittal plane, with low complication rates and high fusion success.