Comparative Analysis between Minimally Invasive and Open Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Spinal Stenosis and Lumbar Spondylolisthesis

Abstract

Introduction To compare the effectiveness between minimally invasive transforaminal lumbar interbody fusion (TLIF) and open TLIF for the treatment of lumbar spinal stenosis and lumbar spondylolisthesis. Materials and Methods A total of 84 cases separated randomly into Mini-TLIF group and open group were involved in the prospective study from August 2012 to July 2013. All patients underwent Mini-TLIF or open TLIF by the same group of surgeons. Operation time, length of incision, volume of blood loss, volume of postoperation drainage, intraoperative fluoroscopy time, and postoperative ambulation time were compared according to different surgical levels. Changes of VAS and CPK around the surgery were calculated. Length of hospital stay and cost were also counted and analyzed. Results In cases with single-level disorders, compared with open TLIF, length of incision, volume of postoperative drainage, length of postoperative ambulation time, and hospital stay were less, but operation and fluoroscopy time were much longer for Mini-TLIF ( p < 0.05). There were no differences between the two groups in volume of blood loss, cost, and changes of VAS and CPK. In cases with two-level disorders, volume of postoperative drainage was less for Mini-TLIF versus open TLIF, but operation and fluoroscopy time during operation were much longer ( p < 0.05). There were no differences in other terms between the two groups. Conclusion In treatment of lumbar spinal stenosis and lumbar spondylolisthesis, for those cases with single-level disorders, Mini-TLIF has smaller incision, reduced volume of postoperative drainage, decreased postoperative ambulation time, and shorter hospital stays with the same efficiency, but will take more time for operation and fluoroscopy. As for those with two-level disorders, Mini-TLIF has reduced postoperative drainage, but needs more time for operation and fluoroscopy.