Hybrid technique for posterior lumbar interbody fusion

Ralph J Mobbs, MD1,2,3, Praveenan Sivabalan, MD2,3, Jane Li, MD2,3, Peter Wilson, MD1,2, Prashanth J Rao, MD1,2,3


The authors describe a hybrid technique that involves a combination of open decompression and posterior lumbar interbody fusion (PLIF) and percutaneously inserted pedicle screws. This technique allows performance of PLIF and decompression via a midline incision and approach without compromising operative time and visualization.

Furthermore, compared to standard open decompression, this approach reduces post-operative wound pain because the small midline incision significantly reduces muscle trauma by obviating the need to dissect the paraspinal muscles off the facet joint complex and by avoiding

1Department of Neurosurgery, Prince of Wales Private Hospital, Sydney, 2Neuro Spine Clinic, Randwick, and 3University of New South Wales, Kensington, New South Wales, Australia


Degenerative lumbar spondylolisthesis is a challenging clinical entity.When associated with lumbar canal and/or foraminal stenosis, patients present with claudicant and/or radicular symptoms, respectively. Surgical intervention provides more positive outcomes than conservative management. The spondylolisthesis arm of the spine patient outcomes research trial (SPORT) concluded that in a non-randomized as-treated environment (with control of potentially confounding baseline factors), after 2 years outcomes were significantly better in regards to pain and function for patients with degenerative spondylolisthesis and spinal stenosis than for those treated non-surgically (SPORT Trial)1. The correlation with mechanical low back pain is less clear and will not be discussed here.


Percutaneous Lumbar Pedicle Screws; Posterior Lumbar Interbody Fusion; Technique, 80/20; Technique, Hybrid; Spondylolisthesis


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