Percutaneous Transforaminal Lumbar Interbody Fusion for the Treatment of Degenerative Lumbar Instability

Abstract

pTLIF allows for safe and efficient minimally invasive treatment of single and multilevel degenerative lumbar instability with good clinical results. Further prospective studies investigating long-term functional results are required to assess the definitive merits of percutaneous instrumentation of the lumbar spine.

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

“…Symptomatic misplaced pedicle screws (2%) and cage migration (2%) were also reported. Our complication and reoperation rates appear comparable to other results of minimally invasive transforaminal lumbar interbody fusion [3,4,6,8,14,16,19,[22][23][24][25]. In the series of Rouben et al [22], the overall rate for repeat surgery (14.2%) was higher than ours.…”

“…Multiple studies have reported favorable results after treatment of spondylolisthesis and other degenerative lumbar diseases with minimally invasive transforaminal lumbar interbody fusion [3,4,6,8,16,17,[20][21][22][23][24][25]. These studies described results from 6 to 49 months after surgery; however, to our knowledge, data at minimum 5-year followup have never been reported.…”

“…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. Putative benefits of minimally invasive transforaminal lumbar interbody fusion, compared with a traditional open approach, include less postoperative pain, reduced blood loss, earlier rehabilitation, shorter hospitalization, and fewer complications [4,6,21,23,24]. This technique also has disadvantages, including longer operative time and a steep learning curve compared with conventional open methods [4,6,16,19,21,24].…”

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

“…Four studies were removed because they included the same, or a subset of the patient population of their previous studies [16][17][18][19]. One study analyzed three groups of patients (divided by the number of operative levels) [12]. We only included the single level group because the patient's number of multilevel fusion procedures was not large enough to meet our inclusion criteria.…”

“…However, only limited Class I evidence is available [4,[6][7][8][9][10][11][12][13][14][15][16][17][18][19]. The objective of the present study was to provide cumulative effect estimates of the clinical and radiological outcomes using meta-analysis and to determine which surgical technique was more beneficial.…”