Introduction: Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) represents an evolution in spinal surgery. When compared to the normal “open” technique, MI-TLIF is much more versatile providing more relief from spinal stenosis, spondylolisthesis, scoliosis and more. Not only does it provide relief, but this innovative technique also provides collection of local bone graph, which can easily be used to induct the ossification between the newly fused vertebrae.
Methods: 243 patients between November 2011 and November 2015 were treated with MI-TLIF. Preoperative evaluation including X-Rays, MRIs, and CT scans were used to determine the source of the back pain and the best possible treatment for optimal clinical outcomes. A BoneBac TLIF device was used to collect autograft tissue to insert into the disc space. Instrumented fusion was achieved with the use of percutaneous pedicle screws.
Results: Long-term clinical observations (5 years) have been done. Four measurements were used to evaluate postoperative patients at 12, 24, and 47 months. A physical analogue back pain scale, Oswestry disability index, and the SF-36 mental/physical component scores were used. All showed statistical significance (P<.05). Furthermore, adjacent segment disease over a 5-year post-operative period has been approximately 2% compared to 13.6% in traditional open lumbar arthrodesis.
Conclusions: The data collected shows that MI-TLIF provides better clinical outcomes than open TLIF. MI-TLIF provides both short- and long-term statistically significant outcome improvements in patients experiencing low back pain. There were high rates of fusion and low rates of complication. Patients show high levels of satisfaction with the MI-TLIF surgery and many patients become completely pain free within 2-5 years.
Patient Care: The minimally invasive procedure has better patient outcomes, less blood loss, decreased incidence of complication, and shorter hospital stays.
Learning Objectives: To show the advantages of minimally invasive spinal surgery over traditional open techniques