Comparison of minimally invasive and open transforaminal lumbar interbody fusion in the treatment of single segmental lumbar spondylolisthesis: minimum two-year follow up

Wu, Ai-Min; Hu, Zhichao; Li, Xiaobin; Feng, Zhenhua; Chen, Dong; Xu, Hui; Huang, Qi-Shan; Lin, Yan; Wang, Xiangyang; Zhang, Kai; Zhao, Jie; Ni, Wen-Fei

doi:10.21037/atm.2018.02.11

Cited by 32 publications

(26 citation statements)

References 32 publications

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“…However, at 2-year follow-up, there was no discrepancy regarding clinical and radiological outcome parameters. Wu et al [24] compared minimally invasive TLIF to open TLIF in 167 patients with grade II or less spondylolisthesis and verified a similar superiority of minimally invasive TLIF regarding blood loss and postoperative hospital stay, but no difference in the functional and radiological outcomes.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Transforaminal Lumbar Interbody Fusion for the Surgical Management of Post-Discectomy Syndrome

et al. 2020

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Study Design: This was a prospective case series of 30 patients with post-discectomy syndrome with an average of 18 months of follow-up (level IV).Purpose: The efficacy of post-discectomy syndrome managed by minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF) was evaluated.Overview of Literature: In post-discectomy syndrome wherein conservative treatment had failed, the best surgical treatment modality still remains controversial.Methods: Patients were functionally assessed using the Visual Analog Scale (VAS) for low back pain (LBP) and leg pain (LP) and Oswestry Disability Index (ODI). Radiological fusion was confirmed with plain X-rays and when indicated with computed tomography scan at 12 months postoperatively. A total of 30 patients with 37 operated at lumbar levels with failed discectomy surgery who met our inclusion criteria were treated with MIS-TLIF.Results: The ODI of all patients showed significant improvement from a mean of 73.78% preoperatively to 16.67% at 1 month and 14.13% at 12 months postoperatively. The preoperative LBP VAS score (mean, 4.37) showed a significant decrease (<i>p</i> <0.001) to 1.90 at 1 month and 1.10 at 12 months. Preoperative LP VAS score of limb pain averaged 7.53 and showed a significant (<i>p</i> <0.001) decrease to 3.47 at 1 month and 1.10 at 12 months. All patients attained radiological fusion at 12 months.Conclusions: MIS-TILF constitutes a valid and effective treatment option for patients with post-discectomy syndrome.

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Section: Discussionmentioning

confidence: 99%

Minimally Invasive Transforaminal Lumbar Interbody Fusion for the Surgical Management of Post-Discectomy Syndrome

et al. 2020

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“…In our study, the MIS-TLIF technique requires 4-5 cm lengthy skin incision approximately. Although the Wiltse approach with the use of a quadrant channel can reduce the need for muscular stripping, it still requires partial laminotomy to achieve decompression and fusion [18]. Because of the application of endoscopy and progressive tissue dilation, the Endo-TLIF technique is performed with a 1-1.5 cm-length skin incision and entirely preserves the function of paraspinal muscles.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have shown that advanced MIS-TLIF is associated with less blood loss and a shorter recovery time than conventional open surgery, but laminotomy, facetectomy and avum dissection are necessary in order to achieve interbody fusion with the use of cages. Meanwhile, this technique still questioned by its limited workspace and the eld of vision of this surgical procedure, steep learning curve, and may higher incidence of complications [18].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Early Outcomes between Percutaneous Endoscopic and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Spondylolisthesis

Zhang¹,

Zhou²,

Wang³

et al. 2020

Preprint

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BackgroundWith the rapid development of less-invasive techniques, the percutaneous endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) as a novel minimal surgical technique for treating lumbar spondylolisthesis in recent years. To compare the preliminary efficacy of Endo-TLIF with that of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for the treatment of lumbar spondylolisthesis.MethodsBetween May and August 2019, 62 patients with single-segment lumbar spondylolisthesis treated by a single surgeon were enrolled in this clinical study: there were 32 patients in the Endo-TLIF group and 30 patients in the MIS-TLIF group. Perioperative parameters, including operative time, estimated blood loss (EBL), interoperative fluoroscopy time, ambulation time and operative complications, were recorded. At preoperatively, 1 week, 3 months, 6 months and 12 months postoperatively, the results of clinical metrics such as the Visual Analog Scale (VAS) for back pain, the Oswestry Disability Index (ODI) and the Japanese Orthopaedic Association (JOA) score were obtained and used to compare early outcomes between the two groups. Postoperative fusion rates were assessed by CT scans 12 months after surgery.ResultsNo significant differences were found in the demographic data, including sex, age, body mass index (BMI), segment distribution and spondylolisthesis severity, between the two groups. Compared with MIS-TLIF group, Endo-TLIF group had a similar operative time (202.6±31.4 minutes), less intraoperative blood loss (73.0±26.0 ml) and a shorter ambulation time (1.6±0.6 days) but had a longer duration of X-ray radiation (46.3±5.1 seconds). The postoperative VAS scores for back pain as well as the ODI and JOA scores were improved compared with the preoperative scores in the two groups, but the Endo-TLIF group showed more significant improvement in the early follow-up. There were no significant differences in terms of the interbody fusion rate between the two groups. However, no obvious postoperative complications were observed in the study.ConclusionEndo-TLIF technique shows relatively better outcomes compared with MIS-TLIF in terms of an early curative effect, especially one week and six months postoperatively.

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“…Currently, the posterior lumbar interbody fusion and transforaminal lumbar interbody fusion are the two main techniques for lumbar degenerative diseases [3] , [12] , [15] , [27] , [28] . However, both the techniques had their disadvantages, such as the retraction of cauda equina and dural sac of the posterior lumbar interbody fusion which will cause the iatrogenic nerve injury [19] and the transforaminal lumbar interbody fusion being more towards the lateral side which will increase the intraoperative blood loss and surgical trauma.…”

Section: Discussionmentioning

confidence: 99%

Optimal medial transforaminal lumbar interbody fusion approach with five extensive options: A simulated study on three-dimensional digital reconstructed images

Tian

et al. 2018

Journal of Orthopaedic Translation

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ObjectiveThe objective of this study is to use 3D digital lumbar models to investigate and simulate the optimal posterior operative approach for safe decompression and insertion of an interbody cage.MethodsThirty lumbar spine (L3-S1) computed tomography data are collected for 3D reconstruction. We cut medial half part of the superior facet and define the distance between the margin of the operative side of the spinous process and the medial margin of the cut superior facet as “medial distance (MD)”. Then, we cut the total superior facet and define the distance between the margin of the operative side of the spinous process and the lateral side of the junction of the pedicle and the vertebral body as “extend distance (ED)”. The feasible insertion of the current standard width size (10 mm and 12 mm) interbody cages was assessed by the two aforementioned MD and ED approaches. Besides the ED, we also simulate four other extensive options of lateral upper, lateral lower, vertical upper and lower and transmedian contralateral decompression on 3D digital lumbar model.ResultsThe MD increased from 13.48 ± 1.28 mm at L3/4 to 18.05 ± 1.43 mm at L5/S1, and the ED increased from 16.64 ± 1.34 mm at L3/4 to 21.12 ± 1.62 mm at L5/S1. To insert a 10-mm-wide cage, 16.7% (left) and 13.3% (right) of MD for L3/4 is not enough, 60.0% (left) and 46.7% (right) of MD for L3/4 is subsafe, 13.3% (left) and 16.7% (right) of MD for L4/5 is subsafe and all others are safe. To insert a 12-mm-wide cage, 76.7% (left) and 60.0% (right) of MD for L3/4 is not enough, 20.0% (left) and 30.0% (right) of MD for L3/4 is subsafe, 13.3%% (left) and 16.7% (right) of MD for L4/5 is not enough, 63.3% (left) and 56.7% (right) of MD for L4/5 is subsafe and 6.7% (left) and 10.0% (right) of MD for L5/S1 is subsafe, whereas 33.3%% (left) and 30.0% (right) of ED for L3/4 is subsafe, 3.3% (left) and 3.3% (right) of ED for L4/5 is subsafe and all others are safe. Besides the ED, on 3D models, four other extensive options could be simulated too and may need to be performed for different special individuals.ConclusionOur 3D digital image study provides a feasible optimal medial transforaminal lumbar interbody fusion approach with five extensive options on lower lumbar region. It can provide safe lumbar decompression and interbody fusion in most population. In addition, surgeons can choose the different extensive options for special individual conditions.The translational potential of this articleTransforminal lumbar interbody fusion is very common used for lumbar degenerative diseases. The optimal medial transforminal lumbar interbody fusion with five options provide a safe and precise approach for surgeons in treatment of lumbar degenerative diseases.

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Comparison of minimally invasive and open transforaminal lumbar interbody fusion in the treatment of single segmental lumbar spondylolisthesis: minimum two-year follow up

Cited by 32 publications

References 32 publications

Minimally Invasive Transforaminal Lumbar Interbody Fusion for the Surgical Management of Post-Discectomy Syndrome

Minimally Invasive Transforaminal Lumbar Interbody Fusion for the Surgical Management of Post-Discectomy Syndrome

Comparison of Early Outcomes between Percutaneous Endoscopic and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Spondylolisthesis

Optimal medial transforaminal lumbar interbody fusion approach with five extensive options: A simulated study on three-dimensional digital reconstructed images

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