Minimal Invasive Surgery in Patients with Degenerative Lumbar Pathology. Initial Experience

Abstract

Introduction The transforaminal lumbar interbody fusion (TLIF) is used traditionally as treatment of the degenerative lumbar disease (DLD), obtaining good results. Nowadays, minimal invasive surgery (MIS) TLIF is being used as a treatment to this pathology, with the purpose of reducing damage in soft tissues, as well as, the operative time and patient recovery. The objective of this study is to measure the in-hospital and surgical parameters of a case series, which had lumbar degenerative pathology surgery using the MIS TLIF technique. Patients and Methods Data of seven patients were collected, who had surgery by the same surgeon at Hospital del Trabajador (Santiago de Chile) during 2013 under the MIS TLIF technique. The operative time, ambulation start, hospital stay, CT fusion, and complications were measured. Results The M/H ratio was 6/1; with an average age of 44.28 ± 10.33 SD. Nine levels (L4–L5: 3 L5–S1: 6) were obtained of the seven patients, who had surgery by DLD under MIS TLIF technique. Two of them were a two-level fusion. The operative time was 169 (range, 145–205) minutes for a one-level fusion and 311 (range, 296–325) minutes for a two-level fusion. The ambulation start was the next day with a hospital stay of 3 (range, 2–3) days. All the surgical levels got a total or partial fusion under CT, with a CT follow-up of 6.91 ± 2.05 SD months. Two cases had a L5 transient paresis. Conclusions The MIS TLIF technique obtained good results of fusion under CT with minor complications. It demonstrates short operative time, early ambulation start with short hospital stay in the patients who had EDL surgery.