Minimally invasive lumbar spine surgery combining extreme lateral internal fusion, percutaneous pedicle screw fixation, and full endoscopic laminectomy for lumbar isthmic spondylolisthesis with spinal stenosis: illustrative case.

BACKGROUND

Patients with lumbar isthmic spondylolisthesis (LIS) and spinal stenosis (SS) are commonly treated with decompression and fusion.

OBSERVATIONS: A 78-year-old male presented with radicular pain, numbness in the posterolateral aspect of both legs, and intermittent claudication. No obvious neurological abnormality was detected. Lumbar radiography and CT showed mild scoliosis and almost grade 2 L4-5 LIS with instability. MRI revealed severe SS at L3-5 and bilateral intervertebral foramen stenosis at L4-5. Combined extreme lateral interbody fusion (XLIF) with percutaneous pedicle screw (PPS) fixation at L4-5 and full endoscopic laminectomy (FEL) at L3-5 were performed under general anesthesia. Postoperative MRI and CT revealed an expanded lumbar canal at L3-5 and decompression of the bilateral L4 and L5 nerve roots. The patient's symptoms resolved postoperatively, and the patient was discharged without perioperative complications.

LESSONS: The combined XLIF with PPS and FEL technique may represent a minimally invasive and effective treatment for patients with SS due to LIS. https://thejns.org/doi/10.3171/CASE251027.