Clinical and radiographic outcomes after minimally invasive transforaminal lumbar interbody fusion

Objective

To evaluate outcomes after minimally invasive transforaminal lumbar interbody fusion (MI-TLIF).

Background

MI-TLIF is a relatively novel technique for treating symptomatic spondylolisthesis and degenerative disc disease of the lumbar spine. It has become a popular option for lumbar arthrodesis largely because of its potential to minimize iatrogenic trauma to the soft tissue, paraspinous muscles as well as to neural elements.

Methods

Literature search using PubMed database.

Results

Eight retrospective clinical studies and 1 prospective clinical study were identified. No randomized studies were found. The indications for surgery were low-back pain and/or radicular symptoms secondary to spondylolisthesis and/or degenerative disc disease. Analysis of radiographic outcomes demonstrated a fusion rate greater than 90% in the vast majority of patients. Patients also experienced a significant improvement in functional outcome parameters at a mean follow-up of 20 months. Comparison of functional outcomes of MI-TLIF patients to a similar matched cohort of patients who underwent conventional open TLIF did not demonstrate any statistically significant difference between both cohorts.

Conclusion

For carefully selected patients, MI-TLIF has a very favorable long term outcome that is comparable to conventional open TLIF, with the added benefit of decreased adjacent tissue injury.