Application and thinking of minimally invasive transforaminal lumbar interbody fusion in degenerative lumbar diseases

Abstract

Background: This study sought to investigate the clinical efficacy and safety of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of lumbar degenerative diseases. Methods: The clinical data of 55 patients with lumbar degenerative diseases treated at our hospital from January 2018 to January 2020 were analyzed retrospectively. Of the 55 patients, 35 who underwent MIS-TLIF were included in the MIS-TLIF group, and 20 who underwent posterior lumbar interbody fusion (PLIF) were included in the PLIF group. The visual analogue scale (VAS) score, Oswestry disability index (ODI) score, operation time, incision length, intraoperative bleeding, postoperative drainage, postoperative landing time, postoperative hospital stay, postoperative interbody fusion rate, and complications were compared between the two groups.Results: The patients in both groups were followed-up for at least 1.5 years (range, 18-30 months; with an average of 27.5±2.6 months). There was no significant difference in the operation time, incision length, intraoperative bleeding, VAS score for low back and leg pain, ODI score, interbody fusion rate, hospitalization expenses, and complication rate between the two groups (P>0.05). One patient had nail failure in the MIS-TLIF group, 1 patient in each group had nerve root irritation, and 1 patient in each group had superficial incision infection and local suture dehiscence. The postoperative drainage volume, postoperative landing time, and postoperative hospital stay of the MIS-TLIF group were less than those of the PLIF group (P<0.05).Conclusions: Compared to PLIF, the use of MIS-TLIF in the treatment of lumbar degenerative diseases has a number of advantages, including more complete intraoperative hemostasis, less postoperative drainage, earlier landing, and faster discharge, and also significantly improves postoperative lumbar discomfort.

Clinical efficacy and complications of MIS-TLIF and TLIF in the treatment of upper lumbar disc herniation: a comparative study

“…Many studies have shown that MIS-TLIF has a longer operative time than open surgery, which is attributed to the steep learning curve of MIS-TLIF and the need for additional intraoperative fluoroscopy to optimize the position of the pedicle screws [ 13 , 14 ]. Price et al investigated 452 patients who underwent TLIF surgery and reported that the MIS-TLIF procedure time was significantly lower than that of TLIF [ 15 ].…”

Clinical Effect of Minimally Invasive Microendoscopic‐Assisted Transforaminal Lumbar Interbody Fusion for Single‐Level Lumbar Disc Herniation

“…The minimally invasive spine surgery innovation and advanced devices promote the minimally invasive TLIF in LDH. 20 , 21 Thus, Foley et al . first proposed minimally invasive TLIF aiming to reduce and avoid intraoperative multifidus stripping and stretching.…”

“…The minimally invasive spine surgery innovation and advanced devices promote the minimally invasive TLIF in LDH 20,21 . Thus, Foley et al .…”

“…[17][18][19] The minimally invasive spine surgery innovation and advanced devices promote the minimally invasive TLIF in LDH. 20,21 Thus, Foley et al first proposed minimally invasive TLIF aiming to reduce and avoid intraoperative multifidus stripping and stretching. 22 While ME-TLIF induces less damage to paravertebral muscles and has better postoperative outcomes compared with conventional TLIF, several studies reported several limitations of ME-TLIF, including incomplete decompression and longer radiation exposure and operation time.…”