Does Conventional Open TLIF cause more Muscle Injury when Compared to Minimally Invasive TLIF?-A Prospective Single...

Area of Science:

• Spine surgery outcomes
• Musculoskeletal research
• Surgical technique comparison

Background:

• Muscle mass reduction after spinal fusion can impact patient recovery.
• Comparing surgical approaches is crucial for optimizing patient outcomes.

Purpose of the Study:

• To quantify and compare the reduction in multifidus muscle mass (MFM) between conventional open transforaminal lumbar interbody fusion (CO-TLIF) and minimally invasive spine transforaminal lumbar interbody fusion (MIS-TLIF).

Main Methods:

• A prospective, observational study included 100 patients undergoing single-level lumbar fusion (L4-L5 or L5-S1) for degenerative pathologies between 2017 and 2020.
• Patients were divided into two groups: 50 treated with CO-TLIF and 50 with MIS-TLIF.
• Magnetic resonance imaging (MRI) was used to assess lean muscle mass (LMM) reduction at 1-year post-surgery, with measurements performed using ImageJ software.

Main Results:

• The CO-TLIF group showed a significantly greater mean percentage reduction in LMM (45.52%) compared to the MIS-TLIF group (25.83%).
• Greater LMM reduction occurred on the side of cage insertion (39.63%) and in females (40.42%).
• A significant, albeit weak, positive correlation was found between age and LMM reduction (r = .22, P = .028).

Conclusions:

• MIS-TLIF leads to less multifidus muscle mass reduction compared to CO-TLIF.
• Factors such as female sex and the side of cage insertion are associated with greater muscle mass reduction.
• Increasing age shows a correlation with increased muscle mass reduction following lumbar fusion.