The recommendations for use of bone graft substitutes and bone graft extenders are based on the strength of the studies and given a grade.

Study Design. A retrospective cohort study at a single institution. Objective. The aim of this study was to analyze the perioperative and postoperative outcomes of patients who underwent open transforaminal lumbar interbody fusion (O-TLIF) and bilateral minimally invasive surgery (MIS) Wiltse approach TLIF (Wil-TLIF). Summary of Background Data. Several studies have compared open TLIF to MIS TLIF; however, comparing the techniques using a large cohort of one-level TLIFs has not been fully explored. Methods. We reviewed the charts of patients undergoing a single-level primary posterior lumbar interbody fusion between 2012 and 2017. The cases were categorized as Open TLIF (traditional midline exposure including lateral exposure of transverse processes) or bilateral paramedian Wiltse TLIF approach. Differences between groups were assessed by t tests. Results. Two hundred twenty-seven patients underwent one-level primary TLIF (116 O-TLIF, 111 Wil-TLIF). There was no difference in age, gender, American Society of Anesthesiologists (ASA), or body mass index (BMI) between groups. Wil-TLIF had the lowest estimated blood loss (EBL; 197 vs. 499 mL O-TLIF, P ≤ 0.001), length of stay (LOS; 2.7 vs. 3.6 days O-TLIF, P ≤ 0.001), overall complication rate (12% vs. 24% O-TLIF, P = 0.015), minor complication rate (7% vs. 16% O-TLIF, P = 0.049), and 90-day readmission rate (1% vs. 8% O-TLIF, P = 0.012). Wil-TLIF was associated with the higher fluoroscopy time (83 vs. 24 seconds O-TLIF, P ≤ 0.001). There was not a significant difference in operative time, intraoperative or neurological complications, extubation time, reoperation rate, or infection rate. Conclusion. In comparing Wiltse MIS TLIF to Open TLIF, the minimally invasive paramedian Wiltse approach demonstrated the lowest EBL, LOS, readmission rates, and complications, but longer fluoroscopy times when compared with the traditional open approach. Level of Evidence: 3

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Selective fusion of thoracic and thoracolumbar/ lumbar curves in adolescent idiopathic scoliosis is a concept critically debated in the literature. While some surgeons strongly believe that a more rigid and straighter spine provides predictably excellent outcomes, some surgeons recommend a mobile and less straight spine. This topic is a crucial part of surgical treatment of idiopathic scoliosis, particularly in young patients who will deal with the stress of the fusion mass at the proximal and distal junctions over many years. This study will review the literature on various aspects of selective fusion.

Level IV, therapeutic.

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

No abstract

Level IV, therapeutic.