Open and Minimally Invasive Transforaminal Lumbar Interbody Fusion: Comparison of Intermediate Results and Complications
Asian Spine Journal
;
: 185-193, 2015.
Article
in English
| WPRIM
| ID: wpr-212957
ABSTRACT
STUDY DESIGN:
Prospective study.PURPOSE:
To compare clinical and radiological outcomes of open vs. minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). OVERVIEW OF LITERATURE MI-TLIF promises smaller incisions and less soft tissue dissection resulting in lower morbidity and faster recovery; however, it is technically challenging.METHODS:
Twenty-five patients with MI-TLIF were compared with 25 matched open TLIF controls. A minimum 2 year follow-up and a statistical analysis of perioperative and long-term outcomes were performed. Potential complications were recorded.RESULTS:
The mean ages for the open and MI-TLIF cases were 44.4 years (range, 19-69 years) and 43.6 years (range, 20-69 years), respectively. The malefemale ratio was 1312 for both groups. Average follow-up was 26.9 months for the MI-TLIF group and 29.3 months for the open group. Operative duration was significantly longer in the MI-TLIF group than that in the open group (p<0.05). No differences in estimated blood loss, duration to ambulation, or length of stay were found. Significant improvements in the Oswestry disability index and EQ-5D functional scores were observed at 6-, 12-, and 24-months in both groups, but no significant difference was detected between the groups. Fusion rates were comparable. Cage sizes were significantly smaller in the MI-TLIF group at the L5/S1 level (p<0.05). One patient had residual spinal stenosis at the MI-TLIF level, and one patient who underwent two-level MI-TLIF developed a deep vein thrombosis resulting in a pulmonary embolism.CONCLUSIONS:
MI-TLIF and open TLIF had comparable long-term benefits. Due to technical constraints, patients should be advised on the longer operative time and potential undersizing of cages at the L5S1 level.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pulmonary Embolism
/
Spinal Stenosis
/
Prospective Studies
/
Follow-Up Studies
/
Walking
/
Venous Thrombosis
/
Operative Time
/
Length of Stay
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Asian Spine Journal
Year:
2015
Type:
Article
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