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Subject Area

Degenerative, Minimally invasive procedures

Article Type

Original Study

Abstract

Back Ground Data: Minimally invasive transforaminal lumbar interbody fusion (MTLIF) has become increasingly popular arthrodesis procedure. It is preferred to treat mechanical back pain due to the advantage of obtaining a circumferential arthrodesis via a unilateral approach with minimal retraction of neural elements. Purpose: The purpose of this study was to describe this new surgical MTLIF using a single cage with pedicular screws and to assess the surgical outcome regarding safety, efficacy, and possible complications in the management of degenerative disorders or isthmic spondylolisthesis of the lumbar spine. Study Design: A retrospective descriptive analytic study. Methods: This retrospective study reviewed 16 consecutive patients who underwent minimally invasive transforaminal lumbar interbody fusion (MTLIF) using a single cage with pedicular screws from January 2008 to August 2011 for the management ofdegenerative disorders or isthmic spondylolisthesis of the lumbar spine. Demographic characteristics, surgical data, and functional outcome data were recorded. Results: There were 9 males and 7 females, with a mean age of 41 years, and a mean follow up period of 15 months. Degenerative spondylolisthesis was diagnosed in 6 patients, stenosis with instability in 5, lytic spondylolisthesis in 4, and failed back surgery in 1. Clinical outcomes were assessed using a visual analog scale, patients’ subjective satisfaction and the Oswestry Disability Index. The mean preoperative Oswestry Disability Index score was 51, decreasing to a mean of 17 postoperatively. The mean leg and back pain visual analog scale scores were 71 and 57, respectively, improving to means of 7 and 18. Fifteen patients (93.7%) were satisfied with the outcome of thesurgery. Fifteen patients (93.7%) showed definite fusion at final follow-up No significant complications were reported.Conclusion: Minimally invasive transforaminal lumbar interbody fusion using a single cage with pedicular screws yielded good clinical outcomes with a low complication rate. This new technique is an effective & safe way to achieve interbody fusion. (1012ESJ017)

Keywords

Minimally invasive surgery, Transforaminal lumbar interbody fusion, instrumented circumferential fusion

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