Minimally Invasive Posterior Lumbar Interbody Fusion: Comparison with Traditional Open Surgery

Abstract

Purpose : To compare the the clinical and radiographic results of the two approaches for posterior lumbar fusion, one-level posterior lumbar interbody fusion (PLIF) performed with a minimally invasive approach or the traditional open approach. Materials and Methods: This study examined a consecutive series of 46 patients who underwent one-level PLIF procedure (27 cases performed with minimally invasive approach and 19 cases with traditional open approach) by one surgeon at one hospital. The following data were compared with a minimum 1-year follow-up: the clinical and radiographic results, surgical time, estimated blood loss, transfusion requirements, postoperative back pain, time needed before ambulation, length of hospital stay, and complications. Results : There was no statistical difference between the two groups in terms of the clinical and radiographic results at the last follow-up. The minimally invasive group was found to have a less blood loss, fewer transfusion requirements, less postoperative back pain, a shorter recovery time, and a shorter hospital stay. However, minimally invasive group required a longer surgical time and there were 2 cases with technical complications. Conclusion : This study confirmed the favorable results reported by previous uncontrolled cohort studies. It also showed that the minimally invasive approach had a similar surgical efficacy to that of traditional open approach. However, minimally invasive technique requires a steep learning curve and attention in order to lower the risk of complications.