Navigation Makes Transforaminal Lumbar Interbody Fusion Less Invasive

Abstract

The current study presents a navigated transforaminal lumbar interbody fusion (TLIF) technique that requires only a 4-cm incision to accomplish a single-level TLIF. The authors compared its efficacy and efficiency with those of conventional TLIF. Forty patients who were indicated for single-level lumbar fusion were included and randomized to either the navigated-TLIF group or the conventional-TLIF group. Intraoperative blood loss, operative time, incision length, complications, bed rest period, and length of hospital stay were recorded. Oswestry Disability Index (ODI) scoring was also performed for each patient preoperatively and 3 months and 2 years postoperatively. Incision length was significantly shorter in the navigated-TLIF group than in the conventional-TLIF group (4.2 vs 8.3 cm, respectively; P=.001). Accordingly, intraoperative blood loss was also significantly less in the navigated-TLIF group than in the conventional-TLIF group (122.5 vs 220.5 mL, respectively; P=.049). There was no significant difference in total operative time between the 2 groups (134.4 vs 124.5 minutes; P=.226). The navigated-TLIF group had a significantly shorter bed rest period and length of hospital stay compared to the conventional-TLIF group. Incision length decreased with time; at final follow-up, average incision length had decreased from 4.2 to 3.7 cm in the navigated-TLIF group and from 8.3 to 7.7 cm in the conventional-TLIF group. Average ODI score improved significantly in both groups immediately postoperatively and was maintained in the following 2 years. Navigation can make single-level TLIF less invasive. Compared with conventional TLIF, navigated TLIF proved to be superior with regard to incision length, intraoperative blood loss, bed rest period, and length of hospital stay. [Orthopedics.2016; 39(5):e857-e862.].

Minimally Invasive versus Conventional Transforaminal Lumbar Interbody Fusion in Treatment of Single-Level Low-Grade Lumbar Spondylolisthesis: A Systematic Review and Meta-Analysis

“…Eleven studies were reported in this systematic review, including four randomized controlled trials (RCT) 40,43,46,48 and seven nonrandomized controlled trials. 2,18,24,28,33,42,44 The summary of our extracted data and reported articles is presented in Based on our meta-analysis, there was no statistical significance between both procedures (P ≤ 0.071) (Figure 2).…”

Intraoperative Cone-Beam Computed Tomography Navigation Versus 2-Dimensional Fluoroscopy in Single-Level Lumbar Spinal Fusion: A Comparative Analysis

“…This is in line with Bovonratwet et al [ 19 ], who showed a significantly shorter mean LOS in the navigated group compared to conventional single-level instrumented posterior lumbar fusion. This finding may be associated with the minimally invasive nature of navigated techniques, which are performed percutaneously, thus making surgical incisions smaller, reducing surgical exposure, and consequently minimizing intraoperative blood loss, as also shown by Wang et al [ 20 ] Diminished blood loss and postoperative pain may result in lower rates of transfusion and complications, thus reducing the need for critical care and allowing for an early patient discharge [ 21 ].…”