J Korean Orthop Assoc.  2012 Dec;47(6):416-424. 10.4055/jkoa.2012.47.6.416.

Perioperative Safety and Efficacy of Multilevel Minimally Invasive Transforaminal Lumbar Interbody Fusion: Comparison with Conventional Open Surgery

• Min SH
• Yoo JS
• Yoon SH
• Rhee CW

• KMID: 2185304
• DOI: http://doi.org/10.4055/jkoa.2012.47.6.416

Abstract

PURPOSE
This study was aimed to examine the ways to reduce bleeding through minimally invasive multi-segmental fusion by comparing the results of minimally invasive transforaminal lumbar interbody fusion versus those of conventional posterior interbody fusion depending on the number of fused segment. Moreover, the study identified how the new method of fusion contributed to reducing postoperative complications and to fast recovery.
MATERIALS AND METHODS
This is a retrospective study conducted on 367 spinal stenosis patients who had been followed up for at least one year (170 patients underwent minimally invasive transforaminal lumbar interbody fusion and 197 patients underwent conventional posterior interbody fusion). The study examined blood loss volume, postoperative drainage volume, operation time, visual analogue scale score, pre- and post-operative levels of protein and albumin, as well as postoperative bed rest period between the two groups. Moreover, the study analyzed the presence of complications during the peri-operative period.
RESULTS
The minimally invasive fusion group exhibited a statistically significant decrease in intraoperative bleeding than the conventional infusion group when the number of fused segments in each group was compared. In addition, the difference in the two groups showed a statistically significant increase as the numbers of fused segments rose (p<0.05). On the other hand, a statistically significant increase was shown in the operation time between the minimally invasive fusion group and the conventional fusion group. The difference in the two groups showed a statistically significant increase as the distance of fused segments was extended (p<0.05).
CONCLUSION
Minimally invasive transforaminal lumbar interbody fusion is thought to be a useful surgical method to minimize bleeding when the limitations of minimal invasive fusion are supplemented by shortening the operation time.

Keyword

multi-level fusion; minimal invasive surgery; complications

MeSH Terms

Bed Rest
Drainage
Hand
Hemorrhage
Humans
Postoperative Complications
Retrospective Studies
Spinal Stenosis

Figure

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  Figure 1 Multilevel MI-TLIF procedure. (A) Preoperative radiography. (B) Postoperative radiography. MI-TLIF, minimally invasive transforaminal lumbar interbody fusion.

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  Figure 2 Comparison of intraoperative blood loss between MI-TLIF and Open surgery stratified by level. Minimal, minimally invasive transforaminal lumbar interbody fusion (MI-TLIF); Open, conventional open surgery.

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  Figure 3 Comparison of surgical time between MI-TLIF and Open surgery stratified by level. Minimal, minimally invasive transforaminal lumbar interbody fusion (MI-TLIF); Open, conventional open surgery.

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