Clinical outcomes of minimally invasive versus open transforaminal lumbar interbody fusion for lumbar revision surgery

English Keywords:Lumbar revision  Minimally invasive  Transforaminal lumbar interbody fusion

English Abstract:

  【Abstract】 Objectives: To compare the safety and effectivity of minimally invasive(MIS) and open transforaminal lumbar interbody fusion(TLIF) for lumbar revision. Methods: From January 2009 to December 2011, 21 patients necessitating single level lumbar revision underwent MIS-TLIF, while 24 cases with the same disorders underwent traditional open TLIF. No significant difference existed for preoperative demographic data(P>0.05). The results of operation time, operative blood loss, postoperative ambulation, and bed time were compared between two groups. Futhermore, clinical outcomes were assessed by visual analogue scores(VAS) for back and leg pain, Oswestry disability index(ODI) and radiographic images at 1 day before surgery and 5 days, 3 months, 6 months and 12 months after surgery. Radiological fusion was assessed by using plain radiography and CT scans at 1 year postoperatively. Results: Operative blood loss, postoperative ambulation time and bed time for MIS-TLIF group were better than Open-TLIF group(P<0.05). 2 cases in two groups suffered from dural tear respectively, but the operation time of MIS-TLIF group was longer than that of Open-TLIF group(P<0.05). The postoperative VAS and ODI scores at 3 months, 6 months and 1 year in two groups were better than the preoperative counterparts(P<0.05). Except for the VAS score for back pain 5 days after operation in MIS-TLIF group were better than that in Open-TLIF group（P<0.05）, no difference existed at any other time point(P>0.05), and no difference existed for fusion rate between two groups at 1 year postoperatively(P>0.05), which was 66.7% for MIS-TLIF group and 62.5% for Open-TLIF group. Conclusions: For single level lumbar revision surgery, MIS-TLIF is safe, minimal invasive and effective.