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Randomized Controlled Trial
. 2013 Dec;22(12):2857-63.
doi: 10.1007/s00586-013-2853-y. Epub 2013 Jun 14.

Clinical outcomes of minimally invasive versus open approach for one-level transforaminal lumbar interbody fusion at the 3- to 4-year follow-up

Javier Rodríguez-Vela  1 , Antonio Lobo-Escolar, Eduardo Joven, Javier Muñoz-Marín, Antonio Herrera, José Velilla
Affiliations
Randomized Controlled Trial

Clinical outcomes of minimally invasive versus open approach for one-level transforaminal lumbar interbody fusion at the 3- to 4-year follow-up

Javier Rodríguez-Vela et al. Eur Spine J. 2013 Dec.

Abstract

Purpose: Supporters of minimally invasive approaches for transforaminal lumbar interbody fusion (TLIF) have reported short-term advantages associated with a reduced soft tissue trauma. Nevertheless, mid- and long-term outcomes and specifically those involving physical activities have not been adequately studied. The aim of this study was to compare the clinical outcomes of mini-open versus classic open surgery for one-level TLIF, with an individualized evaluation of the variables used for the clinical assessment.

Methods: A prospective cohort study was conducted of 41 individuals with degenerative disc disease who underwent a one-level TLIF from January 2007 to June 2008. Patients were randomized into two groups depending on the type of surgery performed: classic open (CL-TLIF) group and mini-open approach (MO-TLIF) group. The visual analog scale (VAS), North American Spine Society (NASS) Low Back Pain Outcome instrument, Oswestry Disability Index (ODI) and the Short Form 36 Health Survey (SF-36) were used for clinical assessment in a minimum 3-year follow-up (36-54 months).

Results: Patients of the MO-TLIF group presented lower rates of lumbar (p = 0.194) and sciatic pain (p = 0.427) and performed better in daily life activities, especially in those requiring mild efforts: lifting slight weights (p = 0.081), standing (p = 0.097), carrying groceries (p = 0.033), walking (p = 0.069) and dressing (p = 0.074). Nevertheless, the global scores of the clinical questionnaires showed no statistical differences between the CL-TLIF and the MO-TLIF groups.

Conclusions: Despite an improved functional status of MO-TLIF patients in the short term, the clinical outcomes of mini-open TLIF at the 3- to 4-year follow-up showed no clinically relevant differences to those obtained with open TLIF.

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Figures

Fig. 1
Fig. 1
Comparison of variables included in the “Lumbar Questionnaire” of the North American Spine Society (NASS) instrument between the MO-TLIF and the CL-TLIF groups (mean values of each item have been represented as follows: intensity value + frequency value / 2)
Fig. 2
Fig. 2
Comparison of the variables of the Oswestry Disability Index (ODI) between the MO-TLIF and the CL-TLIF groups
Fig. 3
Fig. 3
Comparison of the variables included in the Physical Scale of the SF-36 between the MO-TLIF and the CL-TLIF groups
Fig. 4
Fig. 4
Comparison of the scores obtained in the scales included in the SF-36 between the MO-TLIF and the CL-TLIF groups
See this image and copyright information in PMC

References

    1. Harms JG, Jeszenszky D. The unilateral transforaminal approach for posterior lumbar interbody fusion. Oper Orthop Traumatol. 1998;10:90–102. doi: 10.1007/s00064-006-0112-7. - DOI - PubMed
    1. Harms J, Rolinger H. A one-stager procedure in operative treatment of spondylolistheses: dorsal traction-reposition and anterior fusion (author’s transl) Z Orthop Ihre Grenzgeb. 1982;120:343–347. doi: 10.1055/s-2008-1051624. - DOI - PubMed
    1. Rouben D, Casnellie M, Ferguson M. Long-term durability of minimal invasive posterior transforaminal lumbar interbody fusion: a clinical and radiographic follow-up. J Spinal Disord Tech. 2011;24:288–296. doi: 10.1097/BSD.0b013e3181f9a60a. - DOI - PubMed
    1. Mehta VA, McGirt MJ, Garcés Ambrossi GL, Parker SL, Sciubba DM, Bydon A, Wolinsky JP, Gokaslan ZL, Witham TF. Trans-foraminal versus posterior lumbar interbody fusion: comparison of surgical morbidity. Neurol Res. 2011;33:38–42. doi: 10.1179/016164110X12681290831289. - DOI - PubMed
    1. Tsutsumimoto T, Shimogata M, Ohta H, Misawa H. Mini-open versus conventional open posterior lumbar interbody fusion for the treatment of lumbar degenerative spondylolisthesis: comparison of paraspinal muscle damage and slip reduction. Spine. 2009;34:1923–1928. doi: 10.1097/BRS.0b013e3181a9d28e. - DOI - PubMed

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