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Standard versus Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Prospective Randomized Study.

Daniel Serban¹, Niki Calina¹, Gabriel Tender²

¹Bagdasar-Arseni Clinical Hospital, Bucharest, Romania.

Biomed Research International

|July 13, 2017

Summary

Minimally invasive (MI) transforaminal lumbar interbody fusion (TLIF) offers similar outcomes to standard (S) TLIF for spondylolisthesis, with a significantly shorter hospital stay. Both surgical techniques provide comparable clinical and radiological results at one year.

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Area of Science:

Neurosurgery
Orthopedic Surgery
Spinal Fusion Techniques

Background:

Symptomatic spondylolisthesis often requires surgical intervention for decompression and stabilization.
Standard transforaminal lumbar interbody fusion (TLIF) is a common surgical approach.
Minimally invasive (MI) TLIF techniques are emerging as potentially less morbid alternatives.

Purpose of the Study:

To compare the clinical and radiological outcomes of standard (S) TLIF versus minimally invasive (MI) TLIF for low-grade spondylolisthesis.
To evaluate secondary outcomes including operative time, blood loss, hospitalization, and fusion rates.

Main Methods:

A randomized trial comparing S TLIF and MI TLIF was conducted between 2011 and 2015.
Patients with symptomatic, low-grade spondylolisthesis were enrolled.

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The primary outcome was Oswestry Disability Index (ODI) improvement at 1 year; secondary outcomes included surgical metrics and fusion rates.

Main Results:

Operative time and estimated blood loss were not significantly different between the S TLIF and MI TLIF groups.
Patients undergoing MI TLIF had a significantly shorter hospital stay (1.92 days) compared to S TLIF (4.12 days).
Both groups showed similar, statistically significant improvement in ODI scores and high fusion rates (90%) at 1 year.

Conclusions:

Both standard and minimally invasive TLIF techniques yield comparable clinical and radiological outcomes for spondylolisthesis at one year.
Minimally invasive TLIF is associated with a reduced hospital stay, suggesting potential benefits in patient recovery.
Further research may explore long-term outcomes and cost-effectiveness of MI TLIF compared to standard approaches.