Abstract
Background Transforaminal lumbar interbody fusion (TLIF) is an efficient technique which can
achieve a fusion rate of up to 90%. Minimally invasive approaches have become increasingly
popular because they appear to minimize iatrogenic soft tissue and muscle injury.
As minimally invasive TLIF gains popularity, its effectiveness compared with open
TLIF has yet to be established.
Objective A retrospective study was performed with the aim to compare long-term outcomes of
patients who underwent mini-open TLIF with those who underwent open TLIF.
Methods This is a retrospective review of prospectively collected data. Between 2005 and
2008, 100 patients underwent TLIF for low-grade spondylolisthesis or degenerative
disc disease; 60 underwent open TLIF and 40 underwent mini-open TLIF. The mean age
in each group was 48 years, and there were no statistically significant differences
between the groups. Data were collected perioperatively. Pain and functional disability
were measured using visual analogue scale (VAS) and Oswestry disability index (ODI)
at 3 months, 6 months, 1 year, and 2 years. In addition, the fusion was evaluated
at 1 year on a computerized tomography (CT) scan.
Results The mean VAS improved from 7.3 to 3.8 for back pain and from 7 to 2.7 for leg pain
and the ODI decreased from 60 to 30% at 2 years postoperatively. The fusion rate at
1 year was 98%. There were no statistical differences for the clinical and radiological
outcomes between the groups. The mean operative time was 186 minutes in the open group
and 170 minutes in the mini-open group (p < 0.05) and the mean blood loss was 486 mL in the open group and 148 mL in the mini-open
group (p < 0.01).
Conclusion The mini-open TLIF for symptomatic low-grade spondylolisthesis and degenerative disc
disease is an effective option that achieves the same clinical and radiological outcomes
at a minimum 2-year follow-up and reduces perioperative morbidity.
Keywords
minimal invasive spine surgery - spinal fusion - TLIF - outcome
