Surgical Outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion for Highly Migrated Lumbar Disc Herniation

Abstract

Objective To describe minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for highly migrated lumbar disc herniation (LDH) and assess its clinical outcomes. Patients and Methods This research retrospectively assessed 25 patients who were diagnosed with one-segmental highly migrated LDH and underwent MIS-TLIF in Peking University First Hospital from June 2015 to September 2019. Demographic data, perioperative parameters, complications, recurrence, and surgical outcomes were assessed. Results Twelve males and 13 females, with a mean age of 56.68 years old, were involved and the follow-up period was at least one year. The mean operation time was 222.16 minutes, the mean intraoperative hemorrhage was 250.00 mL, and the mean post-operative hospitalization was 5.76 days. The improvements in visual analog scale (VAS) and Oswestry disability index (ODI) were statistically significant. In addition, based on the MacNab criteria, 22 patients (88.0%) acquired satisfactory (good or excellent) results. One patient underwent post-operative epidural hematoma and recovered after evacuation of the hematoma. No recurrence was found. Conclusion MIS-TLIF is safe and effective and it can provide satisfactory clinical outcomes for highly migrated LDH.

Awake spinal fusion: a retrospective analysis of minimal invasive single level transforaminal lumbar interbody fusion done under spinal anaesthesia in 150 cases

“…It implied that the pain outcome of MISTLIF was independent of choice of anaesthesia. 20,21 Mean blood loss reported in our study was 109.64±110.45 ml whereas, Habib et al recorded mean blood loss of 163 ml in MIS TLIF versus 366.8 ml in open TLIF. Schwender et al in his study reported estimated blood loss of 140ml done in general anaesthesia.…”

Evaluation of the safety, efficacy and technical advantages of spinal anesthesia in patients undergoing single lower lumbar level minimally invasive transforaminal lumbar interbody fusion, as an alternative to general anesthesia: a prospective study

“…This shows that the pain improvement in MIS TLIF is independent of the type of anesthesia given. 22,25 In our study we had 11.5% incidence of post operative urinary retention while the incidence of nausea/vomiting was 7%. McLain et al had higher incidence of nausea in general anesthesia group and lower incidence of urinary retention in spinal anesthesia group.…”

Transforaminal Interbody Fusion Using the Unilateral Biportal Endoscopic Technique Compared With Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Spine Diseases: Analysis of Clinical and Radiological Outcomes

“…It is not only possible to preserve the posterior paraspinal muscles with UBE technique, but the arthroscope can also be inserted directly between the two endplates to observe the process of endplate preparation, which can be visualized and magnified. 3 Wang et al 8 used TLIF to evaluate the lumbar fusion results of 25 patients with lumbar disk herniation using VAS and ODI, and the clinical results were satisfactory after 1 year of follow-up. In this study, the estimated surgical blood loss and hospital stay were lower in the UBEIF group than in the TLIF group ( P < .05).…”

“…There are many advantages to minimally invasive surgical techniques over traditional surgery, including surgical trauma, blood loss, postoperative recovery, length of stay, and cost. [5][6][7][8] Unilateral biportal endoscopic technique (UBEIF) is observed and operated through 2 channels via small cuts, where one channel is observed and the other channel is operated without interfering with each other. In addition, instruments for arthroscopic 30°and conventional spinal instruments were used, with the advantage of excellent magnification, economy, and visualization.…”