MIS-TLIF in High-Grade Spondylolisthesis

Spondylolisthesis is a spinal condition in which one vertebral body slips forward over the one below it. The term originates from the Greek words “spondylos” (vertebra) and “olisthesis” (slip). This slippage can result in back pain, neurological symptoms, and progressive spinal deformity, depending on the severity and underlying cause. High-grade spondylolisthesis, typically defined as Meyerding Grade III or higher (greater than 50% slippage), presents a significant surgical challenge due to both the degree of vertebral displacement and the associated disruption in spinal alignment [5, 11]. Symptoms often include mechanical low back pain, radicular leg pain, postural imbalance, and functional disability. Historically, open surgical approaches were used to manage such cases; however, these procedures involve extensive dissection and longer recovery periods. Various surgical approaches have been described for treating spondylolisthesis, including: