Minimally Invasive vs Open Transforaminal Lumbar Interbody Fusion: Early Outcome Observations

Abstract

Aim: To compare early clinical and surgical outcome of patients treated with open transforaminal lumbar interbody fusion (O-TLIF) vs minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Materials and methods: Sixty-two consecutive patients from 2011 to 2013 undergoing transforaminal lumbar interbody fusion (TLIF) for spondylolisthesis and lumbar spinal stenosis were included in the study. For analysis, they were divided into two groups based on whether TLIF was done by a conventional open technique (O-TLIF, 31 cases) or minimally invasive tubular retractor-assisted technique (MIS-TLIF, 31 cases). The demographic profile, clinical and surgical outcome variables, including pre- and postoperative visual analog scale (VAS), Japanese orthopedic association (JOA) scores and JOA recovery rates were noted in both the groups. Results: The median duration of follow-up was 9 months in MIS-TLIF group and 14 months in O-TLIF group. Preoperative clinical variables were comparable in both the groups. MIS-TLIF group had lesser mean intraoperative blood loss, lesser analgesic requirement, shorter hospital stay and earlier return to work as compared to O-TLIF group. Improvements in postoperative VAS for leg pain were similar in both the groups. Immediate postoperative and follow-up VAS for back pain were lower while mean JOA score and mean JOA recovery rate were significantly higher in MIS-TLIF group as compared to O-TLIF group. Conclusion: Minimally invasive transforaminal lumbar interbody fusion resulted in lesser blood loss, lesser analgesic requirement, shorter hospital stay, earlier return to work and improved functional outcome in terms of higher JOA recovery rates as compared to O-TLIF.