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  • Related Quality of Life Outcomes with Minimally Invasive Transforaminal Lumbar Interbody Fusion Based on Long-Term Analysis of 318 Consecutive Patients

    Final Number:
    379

    Authors:
    Mick J. Perez-Cruet MD MS; G. Zachary White BS; Evan M. Begun B.S.; Robert A Collins

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2012 Annual Meeting

    Introduction: Long-term prospective outcomes in patients undergoing minimally invasive spinal fusion for debilitating back pain has not been well studied.

    Methods: 318 patients (mean age 62.7, range 19-94) who underwent MITLIF were followed for 7 years. Patients presented with lumbar spondylolisthesis (236, 74%) and degenerative disc disease (82, 26%). Health care quality of life measures included Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Short From (SF-36).

    Results: 196 females and 122 males were treated. Levels fused included L1-2 (n = 3, 1%), L2-3 (n = 19, 6%), L3-4 (n = 34, 11%), L4-5 (n =163, 51%), L5-S1 (n = 89, 28%), or multi-level instrumentation (n =10, 3%). Estimated blood loss and hospital stay were 128.4 mL and 4.37 days. VAS scores decreased significantly starting at 6 weeks post-op. ODI scores declined from 44.1 preoperatively to 28.1 (p < .05) at one year, and 30.4 (p < .05) at 2-7 year period. SF36 physical component scores (PCS) increased from 30.3 preoperatively to 39.6 (p < .05) at one year, and 38.7 (p < .05) at 2-7 year period. SF36 mental component scores (MCS) increased from 43.7 preoperatively to 48.5 (p < .05) at one year, and 49.1 (p < .05) at 2-7 year period. Fusion rate was 100% at 2-year follow up. Re-operation rate for adjacent level disease was less then 2% over the 7 year period.

    Conclusions: This study presents a large long-term prospective outcomes analysis of MITLIF revealing statistically significant outcome improvements out to seven years. MITLIF resulted in a high rate of spinal fusion and very low rate of adjacent segment disease requiring re-operation. These results highlight the importance of focused surgery and attention to proper indications when selecting patients.

    Patient Care: This research will improve patient care by reducing patient risk and complications while reducing health care cost and improving outcomes.

    Learning Objectives: Review long term outcome analysis of minimally invasive spine fusion for chronic low back pain disorders. Understand patient selection and indications for MITLIF. Review techniques used in achieving outcomes.

    References:

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