Modified Freehand Minimally Invasive Transforaminal Lumbar Interbody Fusion for Single-Level Degenerative Lumbar...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Fusion

Background:

• Conventional minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) presents challenges including soft tissue damage, high reliance on fluoroscopy, and a difficult learning curve.
• Degenerative lumbar spine disease necessitates effective surgical interventions with minimal invasiveness.

Purpose of the Study:

• To introduce and evaluate a modified MIS-TLIF technique for single-level degenerative lumbar spine disease.
• To compare the clinical efficacy and surgical parameters of the modified MIS-TLIF against the traditional approach.
• To identify key technical considerations and advantages of the modified technique.

Main Methods:

• A retrospective analysis of 286 patients with single-level degenerative lumbar disease treated between January 2018 and July 2021.
• Patients were divided into modified MIS-TLIF (n=131) and traditional MIS-TLIF (n=155) groups.
• Clinical outcomes (VAS, ODI, JOA scores) and surgical parameters (operation time, blood loss, fluoroscopy time, complications, multifidus fatty infiltration ratio) were assessed.

Main Results:

• Both groups showed significant postoperative improvement in VAS, ODI, and JOA scores (p<0.05).
• The modified MIS-TLIF group demonstrated significantly shorter operation time, less blood loss, reduced fluoroscopy time, and fewer complications compared to the traditional group.
• The modified MIS-TLIF group also exhibited a lower multifidus fatty infiltration ratio, indicating better muscle preservation.

Conclusions:

• The modified MIS-TLIF technique offers superior preservation of paravertebral muscles.
• This technique leads to reduced radiation exposure, shorter operative times, and decreased complication rates.
• The modified MIS-TLIF presents a more optimized surgical option for single-segment lumbar degeneration.