Abstract
PurposeTo investigate the clinical and radiological outcomes of multilevel minimally invasive transforaminal lumbar interbody fusion (MITLIF) in multilevel degenerative lumbar diseases.MethodsOf 172 patients who could be followed-up for at least 1 year after undergoing a MITLIF, a total of 127 patients in whom unilateral cages were used through a unilateral approach (consisting of 69 patients for single-level, 40 for two-level, and 18 for three- or higher-level) were retrospectively studied as subjects. In this study, clinical assessment parameters included Visual Analog Scale (VAS) score and Oswestry Disability Index (ODI), while radiologic assessment parameters included disc height, segmental lordotic angle, and lumbar lordotic angle. At the last follow-up, the level of bone fusion was determined in accordance with the Brantigan and Steffee criteria for classification of fusion results.ResultsThe VAS scores of back pain and radiating leg pain tended to improve postoperatively, and showed no significant difference among groups (p > 0.05). In terms of ODI, the results of functional assessments also indicated no significant difference among groups (p > 0.05). Similarly, there was no statistically significant difference in disc height, segmental lordotic angle, lumbar lordotic angle, and bone fusion depending on the number of fusion levels (p > 0.05).ConclusionsRegardless of the number of fused levels, satisfactory clinical and radiological outcomes of MITLIF were seen in patients with spinal stenosis, which suggests that the said surgical procedure may be useful even for patients with multilevel spinal stenosis.
Highlights
With recent increases in average life expectancy and degenerative diseases attributed to population aging, the incidence of multilevel degenerative lumbar diseases is rising, and the frequency of multilevel lumbar fusion is getting higher
In terms of Oswestry Disability Index (ODI), the results of functional assessments indicated no significant difference among groups (p [ 0.05)
Regardless of the number of fused levels, satisfactory clinical and radiological outcomes of minimally invasive transforaminal lumbar interbody fusion (MITLIF) were seen in patients with spinal stenosis, which suggests that the said surgical procedure may be useful even for patients with multilevel spinal stenosis
Summary
With recent increases in average life expectancy and degenerative diseases attributed to population aging, the incidence of multilevel degenerative lumbar diseases is rising, and the frequency of multilevel lumbar fusion is getting higher. It was reported that minimally invasive transforaminal lumbar interbody fusion (MITLIF) minimized blood loss and soft tissue damage, reduced postoperative complications and low back pains and contributed significantly to shortening the length of hospital stay and recovery time, suggesting satisfactory clinical and radiological outcomes [6,7,8,9,10]. Many surgeons still believe that multilevel MITLIF has some limitation in providing adequate neural decompression, is difficult to correct the sagittal plane with poly-axial screws, and causes heavier correction loss. They think that higher incidence of fusion failure as a result of insufficient bone grafting leads to poor or unsatisfactory clinical and radiological outcomes. The results of studies concerning single-level MITLIF have been reported, whereas the results of studies addressing fully clinical and radiological outcomes of multilevel MITLIF have not yet been published
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Schedule a callMore From: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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