Methods: This study included 36 patients with HGS in whom reduction, posterior instrumentation, and fusion were achieved with MIS– TLIF. They were evaluated for lower back pain and radicular pain, scaled by Visual Analog Scale (VAS) score. Erect radiographs were performed to calculate slip angle (SA) and sacropelvic and spinopelvic parameters preoperatively, postoperatively, and at each follow-up until 4 years. Results: This study identified 30 patients with grade III HGS and six patients with grade IV/V HGS. Spinopelvic parameters were unbalanced in 13 patients. Complete reduction was achieved in 24 patients, with end-stage reduction of grade I with adequate spinopelvic balance achieved in 12 patients. Intraoperative neuromonitoring demonstrated no loss of signals throughout the procedure in any of the patients. Excellent functional outcome was achieved with back pain as well as leg pain VAS score improvements postoperatively in all patients. No implant-related complications or pseudoarthrosis incidences were reported at long-term follow-up at 4 years. Conclusions MIS–TLIF for HGS is a specific solution for a complex pathology, enabling one to achieve an excellent clinical as well as radiological outcome.

Methods: This study included 36 patients with HGS in whom reduction, posterior instrumentation, and fusion were achieved with MIS– TLIF. They were evaluated for lower back pain and radicular pain, scaled by Visual Analog Scale (VAS) score. Erect radiographs were performed to calculate slip angle (SA) and sacropelvic and spinopelvic parameters preoperatively, postoperatively, and at each follow-up until 4 years. Results: This study identified 30 patients with grade III HGS and six patients with grade IV/V HGS. Spinopelvic parameters were unbalanced in 13 patients. Complete reduction was achieved in 24 patients, with end-stage reduction of grade I with adequate spinopelvic balance achieved in 12 patients. Intraoperative neuromonitoring demonstrated no loss of signals throughout the procedure in any of the patients. Excellent functional outcome was achieved with back pain as well as leg pain VAS score improvements postoperatively in all patients. No implant-related complications or pseudoarthrosis incidences were reported at long-term follow-up at 4 years. Conclusions MIS–TLIF for HGS is a specific solution for a complex pathology, enabling one to achieve an excellent clinical as well as radiological outcome.

Methods: This study included 36 patients with HGS in whom reduction, posterior instrumentation, and fusion were achieved with MIS– TLIF. They were evaluated for lower back pain and radicular pain, scaled by Visual Analog Scale (VAS) score. Erect radiographs were performed to calculate slip angle (SA) and sacropelvic and spinopelvic parameters preoperatively, postoperatively, and at each follow-up until 4 years. Results: This study identified 30 patients with grade III HGS and six patients with grade IV/V HGS. Spinopelvic parameters were unbalanced in 13 patients. Complete reduction was achieved in 24 patients, with end-stage reduction of grade I with adequate spinopelvic balance achieved in 12 patients. Intraoperative neuromonitoring demonstrated no loss of signals throughout the procedure in any of the patients. Excellent functional outcome was achieved with back pain as well as leg pain VAS score improvements postoperatively in all patients. No implant-related complications or pseudoarthrosis incidences were reported at long-term follow-up at 4 years. Conclusions MIS–TLIF for HGS is a specific solution for a complex pathology, enabling one to achieve an excellent clinical as well as radiological outcome.

Methods: Lumbosacral MRI films of patients who visited the outpatient department between January 2023 and March 31, 2024, were evaluated to check for technical inadequacies. Results: A total of 1,150 lumbar MRI sets from 100 MRI centers were examined. Thirty-five percent did not include T1 axial images, and 8% did not include T1 sagittal images. Thirty-eight percent did not specify the sagittal image sequencing (right-to-left or left-to-right). Eighty-five percent of the sagittal images were profiled from right to left, and 15% were profiled from left to right. Macnab’s recommendation was not followed in 970 sets. The axial sectioning of the scout films was nonparallel to the examined segment in 350 sets. The sacroiliac joint was not screened in 40% of the sets. The number of plates provided ranged from two to six films. Conclusions Based on the results obtained, we strongly recommend that radiologists form structured guidelines to be followed by MRI centers to ensure uniformity, address inadequacies, and minimize the chance of errors in diagnosis and subsequent treatment.

Methods: Lumbosacral MRI films of patients who visited the outpatient department between January 2023 and March 31, 2024, were evaluated to check for technical inadequacies. Results: A total of 1,150 lumbar MRI sets from 100 MRI centers were examined. Thirty-five percent did not include T1 axial images, and 8% did not include T1 sagittal images. Thirty-eight percent did not specify the sagittal image sequencing (right-to-left or left-to-right). Eighty-five percent of the sagittal images were profiled from right to left, and 15% were profiled from left to right. Macnab’s recommendation was not followed in 970 sets. The axial sectioning of the scout films was nonparallel to the examined segment in 350 sets. The sacroiliac joint was not screened in 40% of the sets. The number of plates provided ranged from two to six films. Conclusions Based on the results obtained, we strongly recommend that radiologists form structured guidelines to be followed by MRI centers to ensure uniformity, address inadequacies, and minimize the chance of errors in diagnosis and subsequent treatment.

Methods: Lumbosacral MRI films of patients who visited the outpatient department between January 2023 and March 31, 2024, were evaluated to check for technical inadequacies. Results: A total of 1,150 lumbar MRI sets from 100 MRI centers were examined. Thirty-five percent did not include T1 axial images, and 8% did not include T1 sagittal images. Thirty-eight percent did not specify the sagittal image sequencing (right-to-left or left-to-right). Eighty-five percent of the sagittal images were profiled from right to left, and 15% were profiled from left to right. Macnab’s recommendation was not followed in 970 sets. The axial sectioning of the scout films was nonparallel to the examined segment in 350 sets. The sacroiliac joint was not screened in 40% of the sets. The number of plates provided ranged from two to six films. Conclusions Based on the results obtained, we strongly recommend that radiologists form structured guidelines to be followed by MRI centers to ensure uniformity, address inadequacies, and minimize the chance of errors in diagnosis and subsequent treatment.