Minimally Invasive Lumbar Fusion

Foley, Kevin T.; Holly, Langston T.; Schwender, James D.

doi:10.1097/01.brs.0000076895.52418.5e

Cited by 501 publications

(421 citation statements)

References 39 publications

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“…The advantages associated with MI-TLIF might be attributed to less intraoperative dissection and retraction of paravertebral muscles [1,2,5]. Shunwu et al [6] found the minimally invasive group was associated with a significantly lower creatine kinase (a marker of muscle injury) level on the third postoperative day.…”

Section: Discussionmentioning

confidence: 99%

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Minimally invasive versus open transforaminal lumbar interbody fusion: a meta-analysis based on the current evidence

et al. 2013

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Purpose This is a meta-analysis of randomized and nonrandomized studies comparing the clinical and radiological efficacy of minimally invasive (MI) and conventional open transforaminal lumbar interbody fusion (open-TLIF) for degenerative lumbar diseases. Methods A literature search of the MEDLINE database identified 11 studies that met our inclusion criteria. A total of 785 patients were examined. Pooled estimates of clinical and radiological outcomes, and corresponding 95 % confidence intervals were calculated. Results The pooled data revealed that MI-TLIF was associated with less blood loss, shorter hospital stay, and a trend of better functional outcomes when compared with open-TLIF. However, MI-TLIF significantly increased the intraoperative X-ray exposure. Both techniques had similar operative time, complication rate, and re-operation rate. Conclusions Based on the available evidence, MI-TLIF for degenerative lumbar diseases might lead to better patient-based outcomes. MI-TLIF would be a promising procedure, but extra efforts are needed to reduce its intraoperative radiation exposure. More randomized controlled trials are needed to compare these two surgical options.

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Section: Discussionmentioning

confidence: 99%

“…These concerns are often associated with the stripping of paravertebral muscles [1,2]. To address these problems, Foley et al [5] described an alternative technique: minimally invasive TLIF (MI-TLIF). MI-TLIF was developed with the advancement of modern surgical instrumentation and optical systems [1].…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive versus open transforaminal lumbar interbody fusion: a meta-analysis based on the current evidence

et al. 2013

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“…In the past few years, many authors have reported the advantages of the mini-invasive posterior lumbar approach versus the conventional open procedures such as the reduction of intra-operative blood loss, less damage to soft tissues, relief of postoperative pain, early mobilization of the patient, shorter hospital stay, and a rapid return to an active social and working life [5,6].…”

Section: Introductionmentioning

confidence: 99%

A minimally invasive posterior lumbar interbody fusion for degenerative lumbar spine instabilities

et al. 2011

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“…Transforaminal lumbar interbody fusion utilizes a unilateral approach that allows for simultaneous neural canal decompression with an anterior interbody arthrodesis through a single posterior incision [8,11]. This procedure diminishes neural retraction and reduces the risk of neural injury compared with bilateral posterior lumbar interbody fusion [8,12,28].…”

Section: Introductionmentioning

confidence: 99%

“…This procedure diminishes neural retraction and reduces the risk of neural injury compared with bilateral posterior lumbar interbody fusion [8,12,28]. It is possible to perform unilateral posterior surgery using less invasive approaches to neural decompression and intervertebral arthrodesis through a tubular retractor and by augmenting the fusion construct with percutaneous pedicle screw instrumentation.…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Transforaminal Lumbar Interbody Fusion for Spondylolisthesis and Degenerative Spondylosis: 5-year Results

Park

Lee

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Multiple studies have reported favorable short-term results after treatment of spondylolisthesis and other degenerative lumbar diseases with minimally invasive transforaminal lumbar interbody fusion. However, to our knowledge, results at a minimum of 5 years have not been reported. Questions/purposes We determined (1) changes to the Oswestry Disability Index, (2) frequency of radiographic fusion, (3) complications and reoperations, and (4) the learning curve associated with minimally invasive transforaminal lumbar interbody fusion at minimum 5-year followup. Methods We reviewed our first 124 patients who underwent minimally invasive transforaminal lumbar interbody fusion to treat low-grade spondylolisthesis and degenerative lumbar diseases and did not need a major deformity correction. This represented 63% (124 of 198) of the transforaminal lumbar interbody fusion procedures we performed for those indications during the study period (2003)(2004)(2005)(2006)(2007). Eighty-three (67%) patients had complete 5-year followup. Plain radiographs and CT scans were evaluated by two reviewers. Trends of surgical time, blood loss, and hospital stay over time were examined by logarithmic curve fit-regression analysis to evaluate the learning curve. Results At 5 years, mean Oswestry Disability Index improved from 60 points preoperatively to 24 points and 79 of 83 patients (95%) had improvement of greater than 10 points. At 5 years, 67 of 83 (81%) achieved radiographic fusion, including 64 of 72 patients (89%) who had single-level surgery. Perioperative complications occurred in 11 of 124 patients (9%), and another surgical procedure was performed in eight of 124 patients (6.5%) involving the index level and seven of 124 patients (5.6%) at adjacent levels. There were slowly decreasing trends of surgical time and hospital stay only in single-level surgery and almost no change in intraoperative blood loss over time, suggesting a challenging learning curve. Conclusions Oswestry Disability Index scores improved for patients with spondylolisthesis and degenerative lumbar diseases treated with minimally invasive transforaminal lumbar interbody fusion at minimum 5-year followup. We suggest this procedure is reasonable for properly selected patients with these indications; however, traditional approaches should still be performed for patients with high-grade spondylolisthesis, patients with a severely collapsed disc space and no motion seen on the dynamic radiographs, patients who need multilevel decompression and arthrodesis, and patients with kyphoscoliosis needing correction.

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Minimally Invasive Lumbar Fusion

Cited by 501 publications

References 39 publications

Minimally invasive versus open transforaminal lumbar interbody fusion: a meta-analysis based on the current evidence

Minimally invasive versus open transforaminal lumbar interbody fusion: a meta-analysis based on the current evidence

A minimally invasive posterior lumbar interbody fusion for degenerative lumbar spine instabilities

Minimally Invasive Transforaminal Lumbar Interbody Fusion for Spondylolisthesis and Degenerative Spondylosis: 5-year Results

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