• Users Online: 509
  • Print this page
  • Email this page
ORIGINAL ARTICLE
Year : 2019  |  Volume : 2  |  Issue : 2  |  Page : 138-145

A comparative prospective study of clinical and radiological outcomes between open and minimally invasive transforaminal lumbar interbody fusion


Department of Orthopaedics, Seth G. S. Medical College and King Edwards Memorial Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Aditya Anand Dahapute
King Edwards Memorial Hospital, 6th Floor New Building, Ortho Office, Parel, Mumbai - 400 012, Maharashtra
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/isj.isj_40_17

Get Permissions

Context: Fusion of lumbar spine is one of the standards of care for various pathologies such as lumbar canal stenosis and spondylolisthesis. Transforaminal lumbar interbody fusion (TLIF) achieves the necessary goals but with greater muscular trauma due to denervation and loss of muscle mass which may result in poor short-term outcomes. Minimally invasive-TLIF (MIS-TLIF) overcomes these shortcomings by preserving the muscle mass by splitting and dilating the muscles. Aims: The goals of the minimally invasive procedures are to reduce iatrogenic muscle injury, postoperative pain, and disability without compromising on the goals of the surgery. Aim of this study was to compare the 1-year postoperative results of TLIF by a minimally invasive technique and open approach in relation to improvement in functional outcome and interbody fusion. Settings and Design: This was a prospective study. Subjects and Methods: We performed a comparative prospective study on 80 patients. All patients were followed up for minimum of 1-year postoperatively. Functional outcome in all patients was assessed by visual analog scale (VAS), Oswestry Disability Index (ODI), and short form-36 (SF-36) scores. Creatinine phosphokinase (CPK) was assessed at the third-day postoperatively. All patients were radiologically assessed with X-rays and computed tomography scans at 1 year to assess fusion. Statistical Analysis Used: SPSS version 17 was used for analysis. P < 0.05 was considered to be statistically significant. Results: We found that CPK levels as measured on the 3rd-day postoperatively were less (statistically significant) in MIS-TLIF group (16.56 + 4.41 u/L vs. 24.52 + 7.2 u/L). The functional outcomes of the patient measured by VAS, modified ODI, and SF-36 were significantly improved (P < 0.05) at the end of 6 weeks, but long-term outcomes were not statistically significant. However, radiation exposure was increased in MIS-TLIF. Conclusion: It can be safely concluded that the immediate postoperative benefits of MIS-TLIF are better compared to open group due to lesser tissue trauma which corresponds to better functional outcome to the patients. However, the outcomes at 1-year follow-up were equal and comparable to the open TLIF.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed70    
    Printed5    
    Emailed0    
    PDF Downloaded28    
    Comments [Add]    

Recommend this journal