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. 2025 Jan 15;50(2):81-87.
doi: 10.1097/BRS.0000000000005024. Epub 2024 May 6.

Temporal Trends of Improvement After Minimally Invasive Transforaminal Lumbar Interbody Fusion

Pratyush Shahi  1 , Tejas Subramanian  1   2 , Olivia Tuma  1 , Sumedha Singh  1 , Kasra Araghi  1 , Tomoyuki Asada  1 , Maximilian Korsun  1 , Nishtha Singh  1 , Chad Simon  1 , Avani Vaishnav  1 , Eric Mai  1 , Joshua Zhang  1 , Cole Kwas  1 , Myles Allen  1 , Eric Kim  1 , Annika Heuer  1 , Evan Sheha  1 , James Dowdell  1 , Sheeraz Qureshi  1 , Sravisht Iyer  1
Affiliations

Temporal Trends of Improvement After Minimally Invasive Transforaminal Lumbar Interbody Fusion

Pratyush Shahi et al. Spine (Phila Pa 1976). .

Abstract

Study design: Retrospective review of prospectively collected data.

Objective: To analyze temporal trends in improvement after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).

Summary of background data: Although several studies have shown that patients improve significantly after MIS TLIF, evidence regarding the temporal trends in improvement is still largely lacking.

Methods: Patients who underwent primary single-level MIS TLIF for degenerative conditions of the lumbar spine and had a minimum of 2-year follow-up were included. Outcome measures were: 1) patient reported outcome measures (PROMs) (Oswestry Disability Index, ODI; Visual Analog Scale, VAS back and leg; 12-Item Short Form Survey Physical Component Score, SF-12 PCS); 2) global rating change (GRC); 3) minimal clinically important difference (MCID); and 4) return to activities. Timepoints analyzed were preoperative, 2 weeks, 6 weeks, 3 months, 6 months, 1 year, and 2 years. Trends across these timepoints were plotted on graphs.

Results: 236 patients were included. VAS back and VAS leg were found to have statistically significant improvement compared to the previous timepoint up to 3 months after surgery. ODI and SF-12 PCS were found to have statistically significant improvement compared to the previous timepoint up to 6 months after surgery. Beyond these timepoints, there was no significant improvement in PROMs. 80% of patients reported feeling better compared to preoperative by 3 months. >50% of patients achieved MCID in all PROMs by 3 months. Most patients returned to driving, returned to work, and discontinued narcotics at an average of 21, 20, and 10 days, respectively.

Conclusions: Patients are expected to improve up to 6 months after MIS TLIF. Back pain and leg pain improve up to 3 months and disability and physical function improve up to 6 months. Beyond these timepoints, the trends in improvement tend to reach a plateau. 80% of patients feel better compared to preoperative by 3 months after surgery.

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Conflict of interest statement

S.A.Q.: Royalties: Stryker K2M, Globus Medical, Inc.; Globus Medical, Inc.: HS2, LLC; Private Investments: Tissue Differentiation Intelligence; Consulting: Stryker K2M, Globus Medical, Inc.; Speaking and/or Teaching Arrangements: AMOpportunities, Globus Medical, Inc.; Board of Directors: Society of Minimally Invasive Spine Surgery; Scientific Advisory Board/Other Office: International Society for the Advancement of Spine Surgery, Cervical Spine Research Society, Lumbar Spine Research Society, North American Spine Society, Association of Bone and Joint Surgeons, Simplify Medical, Inc., LifeLink.com Inc., Society of Minimally Invasive Spine Surgery, Minimally Invasive Spine Study Group, Spinal Simplicity, LLC, Contemporary Spine Surgery, Annals of Translational Medicine. Sravisht Iyer: Innovasis (Research Support), Globus Medical (Speaker’s Bureau), Healthgrades (Advisory Board Member), Stryker (Speaker’s Bureau). The remaining authors report no conflicts of interest.

References

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    1. Huang J, Rabin EE, Stricsek GP, Swong KN. Outcomes and complications of minimally invasive transforaminal lumbar interbody fusion in the elderly: a systematic review and meta-analysis. J Neurosurg Spine. 2021;36:741–752.
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    1. Shahi P, Dalal S, Shinn D, et al. Improvement following minimally invasive transforaminal lumbar interbody fusion in patients aged 70 years or older compared with younger age groups. Neurosurg Focus. 2023;54:E4.
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