Opioid Use after Transforaminal Lumbar Interbody Fusion: A Comparison between Open and Minimally Invasive Surgery

Area of Science:

• Neurosurgery
• Pain Management
• Public Health

Background:

• Opioids are crucial for severe chronic and acute postoperative pain but pose a public health risk due to misuse.
• Spinal fusion surgeries (OTLIF, MTLIF) are associated with significant postoperative pain.
• Opioid consumption varies based on surgical approach.

Purpose of the Study:

• To compare postoperative opioid consumption between open transforaminal lumbar interbody fusion (OTLIF) and minimally invasive transforaminal lumbar interbody fusion (MTLIF).

Main Methods:

• A quantitative, observational, historical cohort study.
• Analyzed 45 patients (34 OTLIF, 11 MTLIF), measuring demographics, surgery type, length of stay, pain control, and opioid use.
• Statistical methods were applied based on variable characteristics.

Main Results:

• The minimally invasive transforaminal lumbar interbody fusion (MTLIF) group consumed less opioids in frequency and dosage across most observation periods.
• Postoperative opioid frequency and dosage were similar between groups immediately after surgery.
• Surgery type, radiculopathy, and radiculitis accounted for up to 50% of significant postoperative pain.

Conclusions:

• Significant differences in opioid consumption exist between OTLIF and MTLIF surgical techniques.
• Findings suggest potential for improved postoperative pain management and reduced opioid use with MTLIF.
• Further research with larger sample sizes is necessary to validate these findings and inform clinical practice.