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Minimally invasive transforaminal lumbar interbody fusion versus open transforaminal lumbar interbody fusion: a technical description and review of the literature

  • Review Article - Spine
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Abstract

Background

Minimally invasive spine surgery (MISS) has been increasingly advocated during the last decade with new studies being reported every year. Minimally invasive spine procedures, such as minimally invasive transforaminal interbody fusion (MI-TLIF), have been introduced to reduce approach-related muscle trauma, to minimise blood loss, and to achieve faster wound healing, quicker ambulation and earlier patient discharge.

Methods

The aim of this article was to give a comprehensive review of the available English literature comparing open TLIF with MI-TLIF techniques published or available online between 1990 and 2014 as identified by an electronic database search on http://www.ncbi.nlm.nih.gov/pubmed. Fourteen relevant studies comparing MI-TLIF and open TLIF cohorts could be identified.

Results and conclusion

MI-TLIF seems to be a valid alternative to open TLIF. Both methods yield good clinical results with similar improvements of Oswestry Disability Index (ODI) and visual analogue scale (VAS) on follow-up. There seems to be no significant differences in clinical outcome and fusion rates on comparison. These results are consistent throughout all reported studies in this review. The most pronounced benefits of MI-TLIF are a significant reduction of blood loss, shorter lengths of hospital stay (LOHS) and lower surgical site infection rates. On the downside, MI-TLIF seems to be associated with significantly higher intraoperative radiation doses, a shallow learning curve, at least in the beginning, longer operating times and potentially more frequent implant failures/cage displacements and revision surgeries.

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Authors and Affiliations

  1. Department of Neurosurgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany

    Martin Vazan, Jens Gempt, Bernhard Meyer, Niels Buchmann & Yu- Mi Ryang

  2. Zentrum für Wirbelsäulentherapie, Klinikum Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden, Germany

    Martin Vazan

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Correspondence to Martin Vazan.

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Funding

No funding was received for this research.

Conflict of interest

B.M.—consulting: DepuySynthes, Brainlab, Medtronic, Ulrich, Spineart, Reliviant; received funding from: DepuySynthes, Brainlab, Medtronic, Ulrich, Reliviant; Royalties/Patent: Ulrich, Spineart.

J.G.—consulting: BrainLab.

All other authors certify that they have no affiliations with or involvement in any organisation or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

This article does not contain any studies with human participants performed by any of the authors.

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Vazan, M., Gempt, J., Meyer, B. et al. Minimally invasive transforaminal lumbar interbody fusion versus open transforaminal lumbar interbody fusion: a technical description and review of the literature. Acta Neurochir 159, 1137–1146 (2017). https://doi.org/10.1007/s00701-017-3078-3

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