A perioperative cost analysis comparing single-level minimally invasive and open transforaminal lumbar interbody fusion

Singh, Kern; Nandyala, Sreeharsha V.; Marquez-Lara, Alejandro; Fineberg, Steven J.; Oglesby, Mathew; Pelton, Miguel A.; Andersson, Gunnar; Isayeva, Darya; Jegier, Briana J.; Phillips, Frank M.

doi:10.1016/j.spinee.2013.10.053

Cited by 128 publications

(95 citation statements)

References 24 publications

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“…The estimated blood loss was generally and significantly lower in the mTLIF group, ranging from 51 to 578 ml in mTLIF and 225 to 961 ml in oTLIF, respectively (n = 13 studies) [10][11][12][13][15][16][17][18][19][20][21][22][23]. Length of hospital stay was short for the mTLIF with a 2.3 to 10.6 days hospitalization compared to 2.9 to 14.6 days for oTLIF(n = 12 studies) [11][12][13][14][15][17][18][19][20][21][22][23]. However the fluoroscopic time was consistently higher in the mTLIF group with a 49 to 106 s of fluoroscopy compared to 16.4 to 44 s for oTLIF (n = 6 studies) [12,15,18,[20][21][22].…”

Section: Surgical Outcomesmentioning

confidence: 97%

“…The articles that included revision surgery (8) or more than a single level treated (6) or without the complications were also excluded. Eventually, 14 studies which met our inclusion criteria were included in the present systematic review [10][11][12][13][14][15][16][17][18][19][20][21][22][23]. The selection process for articles included in the review is shown in Fig.…”

Section: Study Identification and Selectionmentioning

confidence: 99%

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Minimally invasive versus open transforaminal lumbar fusion: a systematic review of complications

Hu¹,

Tang²,

XianPei³

et al. 2016

International Orthopaedics (SICOT)

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Purpose The aim of this study is to compare mTLIF vs. oTLIF with regard to peri-operative complications, operative time, estimated blood loss, fluoroscopic time, and the length of hospital stay. Methods The PubMed and EMBASE databases were searched for relevant articles reporting patients undergoing TLIF, and a comparison between mTILF and oTLIF was performed. The database included patient demographic information, complications, operative time, fluoroscopic time, and the length of hospital stay. Results Fourteen studies were included in this systematic review. The total number of subjects included was 901, of which 455 underwent mTLIF (50 %) and 446 underwent oTLIF (50 %). The operating time for the mTLIF was ranged from 116 to 390 minutes, compared with 102 to 365 minutes for oTLIF, the operating time tended to be longer in the mTLIF group than the oTLIF group. The estimated blood loss was lower in the mTLIF group, ranging from 51 to 578 ml in mTLIF and 225 to 961 ml in oTLIF, respectively. Length of hospital stay was short for the mTLIF with a 2.3 to 10.6 days hospitalization compared to 2.9 to 14.6 days for oTLIF. However the fluoroscopic time was consistently higher in the mTLIF group with a 49 to 106 seconds of fluoroscopy compared to 16.4 to 44 seconds for oTLIF. The complications divided into technical complications and infection complications. The main technical and infection complications included dural tears, screw malposition, and wound infection. Systemic complications included pneumonia, urinary tract infection, and DVT. The numbers of patients with complication was 54 out of 455 (11.87 %) in the mTLIF, and 64 out of 446 (14.35 %) in the oTLIF. Conclusion The review shows mTLIF offers several potential advantages in reducing blood loss and the length of hospital stay, especially lowering the complication rates for patients compared with oTLIF. However, it required much more operative time and radiation exposure. Class I evidence and highquality randomized controlled trials are needed for further study. Keywords Complications . Minimally invasive spine surgery . Transforaminal lumbar interbody fusionTransforaminal lumbar interboby fusion (TLIF) has been widely performed for degenerative lumbar disease since Harms [1] popularized the procedure. It provides circumferential spinal fusion, restores disc height, and maintains the normal lordosis of the lumbar spine. Due to these advantages and good fusion rates in 95 % [2-6], TLIF has been proven as a safe and effective technique in the past three decades. However, extensive paravertebral muscle stripping and retraction during the procedure to obtain an adequate surgical field causes significant soft tissue injury. This iatrogenic

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Section: Surgical Outcomesmentioning

confidence: 97%

Section: Study Identification and Selectionmentioning

confidence: 99%

Minimally invasive versus open transforaminal lumbar fusion: a systematic review of complications

Hu¹,

Tang²,

XianPei³

et al. 2016

International Orthopaedics (SICOT)

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“…Variations of 100 ml (MIS TLIF) versus 450 ml (OPEN TLIF) and 456 ml versus 951 ml, respectively, have been documented, 7,8 as well as 77 ml (MIS TLIF) versus 461 ml (OPEN TLIF), 124 ml in MIS TLIF versus 295 ml in OPEN TLIF, 200 ml in MIS TLIF versus 296 ml in OPEN TLIF, 124.4 in MIS TLIF versus 380.3 ml in OPEN TLIF, and 50.6 ml in MIS TLIF versus 447.4 in OPEN TLIF. 1,2,5,9 A total of 22 studies have shown a significant difference with an interval of 256 ml between MIS TLIF and OPEN TLIF, being significantly less with the minimally invasive technique.…”

Section: Introductionmentioning

confidence: 99%

“…12 Hospital stay: In most studies, the duration of the hospital stay for patients who underwent MIS TLIF was significantly shorter than OPEN TLIF, 4.7 days for MIS TLIF versus 8 days for OPEN TIF, as well as a difference of 1 day between MIS TLIF and OPEN TLIF, 3 days for MIS TLIF versus 5 days for OPEN TLIF, 6.1 days versus 8.2 days for MIS TLIF versus OPEN TLIF, respectively, and 3.2 days for MIS TLIF versus 6.8 days for OPEN TLIF. 1,2,8,9 A total of 18 studies reported a significant difference with a decrease of 1.3 days between MIS TLIF and OPEN TLIF. 13 Exposure to radiation: Most studies report higher exposure to radiation in MIS TLIF, ranging from 45.3 to 106 seconds as compared to 24-39 seconds for OPEN TLIF.…”

Section: Introductionmentioning

confidence: 99%

“…Another study showed a difference of 37 seconds longer in MIS TLIF than in the OPEN TLIF procedure, as well as an average of 17 3,10 One study reported a significant difference in exposure to radiation of 2.7cGy/cm 2 for MIS TLIF and 1.8cGy/cm 2 for OPEN TLIF. 8 In a meta-analysis, 8 cohort studies were identified with a total of 619 patients. The time of exposure to the fluoroscope during an OPEN TLIF was 39.42 seconds and 94.21 seconds for MIS TLIF.…”

Section: Introductionmentioning

confidence: 99%

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Tlif-Mis vs Tlif-Open: Cost Evaluation

et al. 2018

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Objective: To evaluate the direct costs of transforaminal lumbar interbody fusion (TLIF) and minimally invasive surgery (MIS) or open technique (OPEN). Methods: The present study is descriptive and retrospective. Sixteen patients with degenerative spinal pathology operated on with the TLIF MIS technique and TLIF OPEN were included over a 13-month period. Days of hospital stay, blood loss, surgical time, medical care and costs were compared. Results: The mean number of days of hospital stay was 6.7 ± 4.3 days with TLIF MIS and 11.1 ± 6.5 days with TLIF OPEN. The blood loss was 307 ± 81.6 ml (range 200-400 ml) with TLIF MIS and 803 ± 701.3 ml (range 200-1800 ml) with TLIF OPEN. The surgical time was 320 ± 92.6 minutes (range 210-500 minutes) in TLIF MIS and 372 ± 95.2 minutes (280-540 minutes) in TLIF OPEN. Conclusions: The difference in surgical costs and time between the two procedures was not statistically significant. There was less bleeding during the TLIF-MIS surgery, as well as a correlation between shorter days of hospital stay proportional to bleeding and surgical time, which translates into a reduction in the cost of these items. Level of Evidence III; Analysis based on alternatives and limited costs.Keywords: Intervertebral disc degeneration; Spinal fusion; Arthrodesis. de 6,7 ± 4,3 días con TLIF MIS y de 11,1 ± 6,5 días con TLIF OPEN. La pérdida sanguínea fue de 307 ± 81, con TLIF MIS y de 803 ± 701,3 ml (rango 200-1800 ml) RESUMO Objetivo: Garantir benefícios econômicos diretos de cada procedimento cirúrgico. Metodologia: apresentar um estudo descritivo e retrospectivo. Dezesseis pacientes com patologia degenerativa de colônias operados com a técnica TLIF MIS e TLIF OPEN foram incluídos durante um período de 13 meses. Foram comparados os dias de internação RESUMEN Objetivo: Evaluar los costos directos de la fusión intersomática lumbar transforaminal (TLIF) de mínima invasión (MIS) o técnica abierta (OPEN). Métodos: El presente estudio es descriptivo y retrospectivo. Se incluyeron 16 pacientes con patología degenerativa de columna intervenidos con la técnica TLIF MIS y TLIF OPEN en un período de 13 meses. Se compararon días de estancia hospitalaria, pérdida sanguínea, tiempo quirúrgico, atención médica y costos. Resultados: La media de días de estancia hospitalaria fue

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Comparative Analysis of Open Versus Minimally Invasive Techniques for Posterior or Transforaminal Lumbar Interbody Fusion

Hwang

Chakravarthy

Kemp

et al. 2019

Evidence for Neurosurgery

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A perioperative cost analysis comparing single-level minimally invasive and open transforaminal lumbar interbody fusion

Cited by 128 publications

References 24 publications

Minimally invasive versus open transforaminal lumbar fusion: a systematic review of complications

Minimally invasive versus open transforaminal lumbar fusion: a systematic review of complications

Tlif-Mis vs Tlif-Open: Cost Evaluation

Comparative Analysis of Open Versus Minimally Invasive Techniques for Posterior or Transforaminal Lumbar Interbody Fusion

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