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Minimally invasive versus open transforaminal lumbar interbody fusion: evaluating initial experience

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Abstract

The aim of this study was to compare our experience with minimally invasive transforaminal lumbar interbody fusion (MITLIF) and open midline transforaminal lumbar interbody fusion (TLIF). A total of 36 patients suffering from isthmic spondylolisthesis or degenerative disc disease were operated with either a MITLIF (n = 18) or an open TLIF technique (n = 18) with an average follow-up of 22 and 24 months, respectively. Clinical outcome was assessed using the visual analogue scale (VAS) and the Oswestry disability index (ODI). There was no difference in length of surgery between the two groups. The MITLIF group resulted in a significant reduction of blood loss and had a shorter length of hospital stay. No difference was observed in postoperative pain, initial analgesia consumption, VAS or ODI between the groups. Three pseudarthroses were observed in the MITLIF group although this was not statistically significant. A steeper learning effect was observed for the MITLIF group.

Résumé

Le but de cette étude est de comparer notre expérience de l’arthrodèse lombaire intercorporéale transforaminale par voie mini invasive (MITLIF) ou par voie sanglante classique (TLIF). 36 patients présentant un spondylolisthésis isthmique ou discopathie dégénérative ont été traités soit par MITLIF (n = 18) soit par voie sanglante TLIF (n = 18), le suivi moyen étant respectivement de 22 et 24 mois. Le devenir clinique a été évalué selon l’échelle visuelle analogique (VAS) et le score d’Oswestry (ODI). Il n’y a pas de différence sur la durée opératoire dans les deux groupes. Le groupe MITLIF a des pertes sanguines et une durée moyenne d’hospitalisation inférieures au groupe TLIF. Il n’y a aucune différence observée sur les douleurs postopératoires, dans la consommation d’analgésiques, le score VAS ou le score ODI. Trois pseudarthroses ont été observées avec la technique MITLIF mais la différence n’est pas significative. Une courbe d’apprentissage plus pentue a été observée avec le groupe MITLIF.

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Acknowledgments

Financial support was received in the form of a research grant from DePuy Spine, Inc., Raynham, Massachusetts, USA.

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Authors and Affiliations

  1. Hôpital Orthopédique de la Suisse Romande, Centre Hospitalier Universitaire Vaudois and The University of Lausanne, Lausanne, Switzerland

    Constantin Schizas & Nicolas Tzinieris

  2. Orthopaedic Department, St. James’ University Hospital, Leeds, UK

    Elefterios Tsiridis

  3. Bone and Joint Research Center, Department of Orthopaedic Surgery, University of North Texas Health Science Center, Fort Worth, TX, USA

    Victor Kosmopoulos

  4. Department of Orthopaedic Surgery, John Peter Smith Hospital, Fort Worth, TX, USA

    Victor Kosmopoulos

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  1. Constantin Schizas
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  2. Nicolas Tzinieris
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  3. Elefterios Tsiridis
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  4. Victor Kosmopoulos
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Correspondence to Constantin Schizas.

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Schizas, C., Tzinieris, N., Tsiridis, E. et al. Minimally invasive versus open transforaminal lumbar interbody fusion: evaluating initial experience. International Orthopaedics (SICOT) 33, 1683–1688 (2009). https://doi.org/10.1007/s00264-008-0687-8

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  • DOI: https://doi.org/10.1007/s00264-008-0687-8

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