Predictors of Poor Outcome in Patients Submitted to Minimally Invasive Transforaminal Lumbar Interbody Fusion

Costa, José Torres; Silva, Pedro Santos; Cunha, Marisa; Almeida, Mariana Dias de; Vaz, Ruí; Pereira, Paulo

doi:10.1016/j.wneu.2018.06.207

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…MIS-TLIF is a procedure that involves a unilateral dorsal approach to achieve neural decompression and interbody fusion through a tubular retractor system and percutaneous pedicle-screw fixation. [28][29][30] This widely used technique is associated with improved sagittal alignment and a lower risk of iatrogenic nerve injury due to minimal neural retraction.…”

Section: Discussionmentioning

confidence: 99%

Smoking Is Associated With Lower Satisfaction in Nondiabetic Patients Undergoing Minimally Invasive Single-level Transforaminal Lumbar Interbody Fusion

Gatot

Liow

Goh

et al. 2021

Clinical Spine Surgery: A Spine Publication

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This was a retrospective review of prospectively collected registry data.Objective: The objective of this study was to investigate the effect of smoking on 2 years postoperative functional outcomes, satisfaction, and radiologic fusion in nondiabetic patients undergoing minimally invasive transforaminal lumbar interbody fusion (TLIF) for degenerative spine conditions. Summary of Background Data:There is conflicting data on the effect of smoking on long-term functional outcomes following lumbar fusion. Moreover, there remains a paucity of literature on the influence of smoking within the field of minimally invasive spine surgery.Methods: Prospectively collected registry data of nondiabetic patients who underwent primary single-level minimally invasive TLIF in a single institution was reviewed. Patients were stratified based on smoking history. All patients were assessed preoperatively and postoperatively using the Numerical Pain Rating Scale for back pain and leg pain, Oswestry Disability Index, Short-Form 36 Physical and Mental Component Scores. Satisfaction was assessed using the North American Spine Society questionnaire. Radiographic fusion rates were compared.Results: In total, 187 patients were included, of which 162 were nonsmokers, and 25 had a positive smoking history. In our multivariate analysis, smoking history was insignificant in predicting for minimal clinically important difference attainment rates in Physical Component Score and fusion grading outcomes. However, in terms of satisfaction score, positive smoking history remained a significant predictor (odds ratio = 4.7, 95% confidence interval: 1.10-20.09, P = 0.036).Conclusions: Nondiabetic patients with a positive smoking history had lower satisfaction scores but comparable functional outcomes and radiologic fusion 2 years after single-level TLIF. Thorough preoperative counseling and smoking cessation advice may help to improve patient satisfaction following minimally invasive spine surgery.

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Section: Discussionmentioning

confidence: 99%

Smoking Is Associated With Lower Satisfaction in Nondiabetic Patients Undergoing Minimally Invasive Single-level Transforaminal Lumbar Interbody Fusion

Gatot

Liow

Goh

et al. 2021

Clinical Spine Surgery: A Spine Publication

View full text Add to dashboard Cite

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Comparative Outcome Data Using Different Techniques for Posterior Lumbar Fusion: A Large Single-Center Study

Lewis,

Marya,

Carrasco

et al. 2023

Asian Spine J

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Study Design: Retrospective single-center study.Purpose: This study aims to evaluate perioperative and intermediate-term clinical outcomes of patients undergoing different lumbar fusion techniques.Overview of Literature: Various open and minimally invasive techniques for lumbar fusion are available, but previous studies comparing lumbar fusion techniques have heterogeneous data, making interpretation challenging.Methods: Between 2011 and 2018, data from 447 consecutive patients undergoing one/two-level lumbar fusion were analyzed. Posterior lumbar interbody fusion (PLIF) with bilateral muscle strip or Wiltse approach, open transforaminal lumbar interbody fusion (TLIF) and minimally invasive TLIF, and posterolateral fusion only were among the surgical techniques used. Core outcomes measure index (COMI) questionnaires were distributed before surgery and at 3 months, 1 year, and 2 years postoperatively to establish patient selfreported outcome measures. Demographic data (age, gender, and body mass index [BMI]) for each patient were also collected in addition to surgical indication, previous operative history, perioperative outcomes, and complications, and whether later revision surgery was required. Pearson’s chi-square test, Kruskal-Wallis test, repeated measure mixed-effects models, and ordinal logistic regression were used for statistical analysis.Results: Postoperative COMI scores improved across all procedures compared with pre-surgery (p<0.001). There was no significant difference between different postoperative COMI scores. Significant predictors of higher postoperative COMI score included higher pretreatment COMI score (p≤0.001), previous surgery (p≤0.04), younger age (p≤0.05), higher BMI (p≤0.005), and the indications of lytic spondylolisthesis (p=0.02) and degenerative disc disease (p<0.001). Patients undergoing minimally invasive TLIF had a significantly shorter post-surgery stay than patients undergoing open PLIF (Kruskal-Wallis test, p=0.03).Conclusions: At 2 years postoperatively, there was no significant difference in clinical outcomes between open and minimally invasive techniques. These findings suggest that the main determinant of surgical approach should be surgeon preference and training.

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Predictors of Poor Outcome in Patients Submitted to Minimally Invasive Transforaminal Lumbar Interbody Fusion

Cited by 2 publications

References 22 publications

Smoking Is Associated With Lower Satisfaction in Nondiabetic Patients Undergoing Minimally Invasive Single-level Transforaminal Lumbar Interbody Fusion

Smoking Is Associated With Lower Satisfaction in Nondiabetic Patients Undergoing Minimally Invasive Single-level Transforaminal Lumbar Interbody Fusion

Comparative Outcome Data Using Different Techniques for Posterior Lumbar Fusion: A Large Single-Center Study

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