114 Percutaneous Transforaminal Lumbar Interbody Fusion Is Associated with Reduced Postoperative Opioid Consumption When Compared with Minimally Invasive Transforaminal Lumbar Interbody Fusion

Abstract

INTRODUCTION: Opioid use and postoperative pain following lumbar interbody fusion is a common problem for patients during rehabilitation. Less invasive surgical techniques techniques such as minimally invasive transforaminal lumbar interbody fusion (miTLIF) and Percutaneous transforaminal lumbar interbody fusion (pTLIF) have been associated with decreased post-operative pain, estimated blood loss, and shorter hospital length of stay. While pTLIF is a newer technique, its utilization has been increasing and preliminary studies have shown a reduction in post-operative pain, blood loss, faster recovery, and shorter LOS in comparison to miTLIF. METHODS: We performed a multi-surgeon, single institution retrospective analysis on consecutive patients undergoing 1 or 2 level percutaneous or minimally invasive TLIF from January 1, 2018- December 31, 2020. We collected data for each patient regarding time spent in the post-anesthesia care unit (PACU), PACU Visual Analogue Scale (VAS), 24-hour postoperative opioid use, hospital LOS, and documented distance ambulated on post-operative day (POD) 1. RESULTS: There were 37 patients who underwent pTLIF and 70 who underwent miTLIF. The average postoperative 24-hour oral morphine equivalent utilizations for pTLIF and miTLIF patients were 90 mg and 149 mg, respectively (p < 0.004). Time spent in the PACU, PACU VAS, distance ambulated on POD1, and LOS were similar between the two groups. CONCLUSION: Percutaneous TLIF was associated with a 40% reduction in 24-hour postoperative oral morphine equivalent utilization. Larger prospective studies maybe helpful in determining the impact of pTLIF on perioperative outcomes.