Three-year postoperative outcomes between MIS and conventional TLIF in1-segment lumbar disc herniation

Lv, You; Chen, Jingyang; Chen, Jinchuan; Wu, Yue; Chen, Xiangyang; Liu, Yi; Chu, Zhaoming; Sheng, Luxin; Qin, Rujie; Chen, Ming

doi:10.1080/13645706.2016.1273837

Cited by 35 publications

(24 citation statements)

References 22 publications

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“…Open TLIF and Mis‐TLIF are two common types of surgery for LSS. Lv et al 4 . found that Mis‐TLIF was superior to open TLIF in terms of postoperative outcomes and could prevent paraspinal muscle atrophy during the follow‐up period.…”

Section: Discussionmentioning

confidence: 99%

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Psychological and Functional Comparison between Minimally Invasive and Open Transforaminal Lumbar Interbody Fusion for Single‐Level Lumbar Spinal Stenosis

Zhang

Pan

et al. 2021

Orthopaedic Surgery

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The aim of this study was to investigate whether treatment with minimally invasive transforaminal lumbar interbody fusion (Mis-TLIF) causes patients suffering from lumbar spinal stenosis (LSS) to experience less anxiety and better clinical efficacy than open transforaminal lumbar interbody fusion (TLIF). Methods:In this retrospective cohort study, we analyzed 86 patients, including 46 male patients and 41 female patients, who suffered from single-segmental lumbar spinal stenosis in our department between January 2016 and January 2018. They were divided into two groups: a control group (n = 46), for patients who underwent open TLIF surgery, and an experimental group (n = 40), for patients who underwent Mis-TLIF surgery. All patients were evaluated based on operation time, intraoperative blood loss, hospital stay, visual analogue scale (VAS), Oswestry disability index (ODI), hospital anxiety depression scale (HADS), fusion rate, and complications (screw misplacement and loosening, cerebrospinal fluid leakage, infection, and delayed wound healing). Patient characteristics were compared within and between groups. Results:The average incision length was 3.64 AE 0.476 cm in the experimental group, which was smaller than that (8.11 AE 2.406 cm) in the control group (P < 0.05). The operation time of the experimental group was a little longer than that of the control group. The intraoperative blood loss and hospital stay in the experimental group were less than those in the control group. The mean preoperative low back pain VAS score was 7.525 AE 1.432 in the experimental group and 7.087 AE 1.799 in the control group (P > 0.05). The low back pain VAS scores on postoperative day 3 and at 3, 6, and 12 months postoperatively were 5.000 AE 0.987, 4.075 AE 0.997, 2.150 AE 0.834, and 1.450 AE 0.639 in the experimental group, respectively; these scores were lower than those in the control group (6.870 AE 1.572, P < 0.05; 4.630 AE 1.103, P < 0.05; 2.630 AE 1.103, P < 0.05; and 2.326 AE 1.034, P < 0.05, respectively). There was no obvious difference in the leg pain VAS scores between the two groups at all follow-up points. The mean preoperative ODI score was 58.700% AE 19.703% in the experimental group and 61.696% AE 17.583% in the control group (P > 0.05). The ODI scores at postoperative months 3, 6, and 12 were 25.225% AE 5.554%, 20.150% AE 7.698%, and 16.125% AE 9.565% in the experimental group; these scores were lower than those in the control group (49.130% AE 14.805%, P < 0.05; 34.044% AE 15.148%, P < 0.05; and 29.282% AE 132.567%, P < 0.05, respectively).

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Section: Discussionmentioning

confidence: 99%

“…Introduced by Harms in 1982, open TLIF has become a popular and established technology 3 . With the development of minimally invasive spine technology and instruments, Mis-TLIF has gained popularity since being introduced by Foley and Lefkowitz in the early 2000s 4,5 . Both operations are widely used in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Psychological and Functional Comparison between Minimally Invasive and Open Transforaminal Lumbar Interbody Fusion for Single‐Level Lumbar Spinal Stenosis

Zhang

Pan

et al. 2021

Orthopaedic Surgery

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“…However, open conventional TLIF is injurious for the back muscles and soft tissue, making the overall results unsatisfactory [ 15 , 16 ]. Owing to the use of percutaneous screws and the rod assembly system and the advances in the retraction instruments, MIS-TLIF has minimized the limitations of the open conventional method by decreasing intraoperative bleeding, soft tissue damage, postoperative pain, and hospital stay [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical and Radiological Comparison between Three Different Minimally Invasive Surgical Fusion Techniques for Single-Level Lumbar Isthmic and Degenerative Spondylolisthesis: Minimally Invasive Surgical Posterolateral Fusion versus Minimally Invasive Surgical Transforaminal Lumbar Interbody Fusion versus Midline Lumbar Fusion

et al. 2018

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Study DesignRetrospective cohort study.PurposeComparison between three different minimally invasive surgical (MIS) fusion techniques for single-level lumbar spondylolisthesis.Overview of LiteratureThere has been an increase in the development and utilization of MIS techniques for lumbar spine fusion. No study has compared the efficacy of MIS-posterolateral fusion (MIS-PLF), MIS-transforaminal lumbar interbody fusion (MIS-TLIF), and midline lumbar fusion (MIDLF) with modified cortical bone trajectory screws for lumbar spondylolisthesis.MethodsFifty-nine patients with single-level lumbar spondylolisthesis and a minimum follow-up period of 1 year were included in this study. The MIS-PLF, MIS-TLIF, and MIDLF groups included 22, 15, and 22 patients, respectively. The average age of the groups was 70.6, 49.3, and 62.7 years, respectively. The evaluation parameters were operation time, intraoperative bleeding, serum C-reactive protein (CRP) value, creatine kinase (CK) value, and overall functional outcome as per the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) score. The changes in the lumbar lordosis angle (LLA), segmental disc angle (SDA), and disc height were measured. Fusion rate, screw loosening, and loss of correction were also assessed.ResultsMIDLF showed a significantly shorter operation time (111 min), less bleeding amount (112.5 mL), and lower values of CRP and CK than the other two techniques. There was no significant difference in the JOABPEQ scores of the three groups. MIDLF resulted in a greater increase in the LLA and SDA postoperatively. MIDLF and MIS-TLIF resulted in a significant increase in the middle disc height compared with MIS-PLF. MIDLF showed a lower loss of correction after 6 months postoperatively (2.6%) than MIS-PLF (5.2%) and MIS-TLIF (4.2%). The fusion rate was 100% in the MIDLF and MIS-TLIF groups and 90% in the MIS-PLF group. Screw loosening occurred in 10% of the MIS-PLF cases, 7.14% of the MIS-TLIF cases, and 4.76% of the MIDLF cases.ConclusionsMIDLF was the least invasive, and there was no significant difference between the three groups in terms of fusion, screw loosening, and clinical outcomes.

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“…Reducing the need for retraction of the nerve root and thecal sac, avoiding the need and risk to enter the abdominal cavity, preserving the anterior and posterior longitudinal ligaments, not devitalizing adjacent soft tissues, allowing the disc space to be accessed unilaterally, and preserving the contralateral facet complex are strategies that might enhance outcome. In addition, decreased blood loss, decreased postoperative pain, decreased hospital stay, lower infections rates, [24][25][26][27][28][29][30][31] and possibly decreased degeneration of the adjacent spinal levels would be expected to offer further refinement of therapeutic intent. 32 The stated goal of the MIS-TLIF approach is fusion of the painful segments; this has been reported to be equivalent to corresponding open procedures 26,[33][34][35][36][37][38] with fusion rates consistently over 90% when using rh-BMP-2 (InFUSE).…”

Section: Discussionmentioning

confidence: 99%

Transforaminal Lumbar Interbody Fusion With Viable Allograft: 75 Consecutive Cases at 12-Month Follow-up

2018

Int J Spine Surg

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Background: When conservative treatments fail to alleviate the discomfort of abnormal motion, spinal fusion has been shown to provide symptomatic treatment for spinal instability, stenosis, spondylolisthesis, and symptomatic degenerative disc disease. The trend and rates of fusion over the past few years have been dramatic in the United States. Accompanying that higher incidence has been the shifting from traditional open surgery to minimally invasive techniques to reduce scar tissue formation, extent of muscle stripping, and muscle retraction which all have been shown to adversely affect outcomes. Other reasons supporting the widespread transition to minimally invasive surgical (MIS) techniques include decreased postoperative pain, decreased intraoperative blood loss, shorter postoperative hospital stay, faster return to normal activity, and reduced reoperation rates. Spinal fusion procedures rely on a bony fusion substrate in addition to fixation hardware. While available grafting options include autogenous, allogeneic, and synthetic materials, recent interest in viable allograft material with living cells has drawn attention and attraction for incorporating a biologic basis for regenerative consideration. A recent viable allograft, complete with cellular and designated bone carrier (VIA Graft, Vivex Biomedical, Marietta, Georgia) has been developed. This study represents a retrospective review of a single-practice, single-surgeon evaluation of the product in 75 consecutive patients for fusion by computed tomography (CT) and radiographic evaluation at 12 months in conjunction with a MIS approach. Viable allograft was used to fill the peri-implant space, and central implant lumen was filled with a cancellous bone sponge soaked in perivertebral bone marrow. Posterolateral supplementation was attained with beta-tricalcium phosphate as a bulking agent.Methods: A retrospective review identified patients treated for both primary and revision surgery who received VIA Graft cellular bone matrix material in minimally invasive interbody fusion (MIS-TLIF) with a minimum of 12month follow up. The patient diagnoses included radiculopathy in all instances and varied collateral indications such as foraminal collapse, recurrent disc herniation, and spondylolisthesis to which pain and morbidity had been unresolved by conservative treatment. Adverse events including infection, revisions, and evidence of immune response were evaluated and patient comorbidities defined for the entire population of patients. Patient fusion status was assessed using thin slice CT by 2 independent radiologists separate from the surgeon. There were 75 consecutive adult patients with degenerative conditions of the lumbar spine who underwent MIS-TLIF surgery of which 40 (53%) were male and 35 (47%) were female. Mean age, height, and weight were 58 years, 170.18 cm (67 in), and 88.45 kg (195 lbs), respectively. The mean body mass index was 30. There were 16 patients (21%) who smoked and 12 (16%) with a history of diabetes. Independent blinded review of f...

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Three-year postoperative outcomes between MIS and conventional TLIF in1-segment lumbar disc herniation

Abstract: Both MIS and conventional TLIF were beneficial for patients with LDH. However, MIS-TLIF manifests a great improvement in perioperative outcomes, low back pain, disability and preventing paraspinal muscle atrophy during the follow-up period observation.

Cited by 35 publications

References 22 publications

Psychological and Functional Comparison between Minimally Invasive and Open Transforaminal Lumbar Interbody Fusion for Single‐Level Lumbar Spinal Stenosis

Psychological and Functional Comparison between Minimally Invasive and Open Transforaminal Lumbar Interbody Fusion for Single‐Level Lumbar Spinal Stenosis

Transforaminal Lumbar Interbody Fusion With Viable Allograft: 75 Consecutive Cases at 12-Month Follow-up

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