Abstract
Background: Despite numerous reports on mini-open transforaminal lumbar interbody fusion (TLIF), there exists a few studies to compare directly mini-open TLIF and conventional-open TLIF procedures. This study evaluated the usefulness and safety of mini-open TLIF for degenerative lumbar diseases and instabilities. Material and methods: Sixty-eight patients underwent TLIF with pedicle screw fixation for degenerative disc disease or spondylolisthesis with more than 12 months follow-up; 22 patients underwent mini-open TLIF and 46 patients underwent conventional-open TLIF. Data of incision, perioperative parameters, complications, fusion rate, and clinical data were reviewed. Results: The length of incision was shorter in mini-open TLIF group (p=0.04), but satisfaction rate of incision was not statistically different (p=0.18). The VAS and mODI were significant lower in mini-open TLIF (p=0.037, 0.031, respectively) at postoperative 7 days. Less estimated blood loss and less change in hemoglobin and blood pressure during operation was observed in mini-open TLIF group than conventional-open TLIF group. The fusion rate was also not statistically different. The complication including the pedicle screw fracture, bony spur, adjacent level instability was observed in 14% in the mini-open TLIF group and 10% in the conventional-open TLIF group (p=0.63). Conclusion: The mini-open TLIF with pedicle screw fixation provides excellent clinical results and may be an operation of choice for lumbar spinal fusion. The long-term clinical, functional and radiological results were similar in the mini-open and conventional-open TLIF. But, the mini-open TLIF is a viable alternative to the conventional-open TLIF with advantage of lesser blood loss, less change of hemoglobin and blood pressure, shorter incision, and lesser postoperative pain.
Highlights
Harms and Rolinger first introduced the transforaminal lumbar interbody fusion (TLIF) technique in 1982 [1]
The mini-open TLIF is a viable alternative to the conventional-open TLIF with advantage of lesser blood loss, less change of hemoglobin and blood pressure, shorter incision, and lesser postoperative pain
Initial postoperative Visual Analog Scale (VAS) and modified Oswestry Disability Index (mODI) were more improved in mini-open TLIF group (p=0.037 in postoperative 7 days VAS, p=0.048 in postoperative 1 month VAS, and p=0.031 in postoperative 7 days mODI), but no statistically significant difference were observed in VAS and mODI improvement between the groups after postoperative 6 months
Summary
Harms and Rolinger first introduced the transforaminal lumbar interbody fusion (TLIF) technique in 1982 [1]. This TLIF procedure involves the placement of bone graft and an interbody spacer via a posterolateral transforaminal route into a distracted disc space with a supplemental pedicle screw construct. Despite numerous reports on mini-open TLIF [4,5,6,7,8,9], there exist a few studies to compare directly mini-open and conventionalopen TLIF procedures. Despite numerous reports on mini-open transforaminal lumbar interbody fusion (TLIF), there exists a few studies to compare directly mini-open TLIF and conventional-open TLIF procedures. This study evaluated the usefulness and safety of mini-open TLIF for degenerative lumbar diseases and instabilities
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