Introduction: Oblique posterior lateral lumbar fusion (OLLIF) is a surgical procedure designed for a minimally invasive spinal fusion. The OLLIF procedure allows for fusion of the lumbar spine through a single 10-15 mm incision, with faster surgery times and easier approach than any previous technique. In recent years, the rate of disability due to low back pain has increased dramatically, and consequently, costs have skyrocketed. Advancements in the surgical treatment of lower back pain could benefit numerous patients annually and contribute to lower health care costs.

Methods: All procedures were completed by the same surgeon as single surgeon procedures. To eliminate selection bias, the TLIF control group was selected from patients who underwent surgery before the surgeon started performing OLLIF. All 124 procedures were performed in two Minnesota hospitals: Douglas County Hospital, 111 17th Ave E, Alexandria, MN and Riverview Health, 323 Minnesota St, Crookston, MN. Surgeries were performed between March 2012 and December 2013. The study size derives from the number of surgeries accomplished in this time frame.

Results: In all groups, OLLIF significantly reduced surgery times, blood loss, and hospital stay compared to TLIF. In the one level group, mean blood loss was reduced almost 11-fold (p<0.001). In general, blood loss per patient was less in OLLIF when compared with TLIF.

Conclusions: The cost reductions and faster recovery times associated with the OLLIF procedure make it an appealing alternative to the traditional open fusions available for patient and insurance providers. The reduction in the use of these key hospital resources suggests that hospitals that are constrained by OR or hospital bed availability may be able to achieve greater throughput efficiency by increasing the overall percentage of patients receiving the OLLIF surgery.

Patient Care: Therefore, OLLIF justifies further study as it has the potential to significantly improve the outcomes of patients with lumbar fusions. This study further identifies a need for high-quality cost-effectiveness studies comparing open lumbar spine surgeries using MI surgical techniques. Ongoing prospective, multi-centered studies are warranted to describe the resource consumption further.

Learning Objectives: MI surgical techniques are available for treating a wide range of clinical indications in the lumbar spine. In general, clinical outcomes following MIS procedures compare favorably to traditional open surgery [14-16]. OLLIF has been described as the first MI fusion that is faster than open surgery and has been found by the authors to overcome difficulties characteristic of traditional open fusions, thereby, making it a safe and reliable alternative to open or MI TLIF [9-11] While these and other data suggest that minimally invasive spine surgery reduces morbidity, hospital stay, and accelerates a patient’s rehabilitation time. This study monetized quantifiable differences in resource utilization between two MI procedures, OLLIF and TLIF.

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