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Clinical outcomes of minimally invasive versus open approach for one-level transforaminal lumbar interbody fusion at the 3- to 4-year follow-up

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Abstract

Purpose

Supporters of minimally invasive approaches for transforaminal lumbar interbody fusion (TLIF) have reported short-term advantages associated with a reduced soft tissue trauma. Nevertheless, mid- and long-term outcomes and specifically those involving physical activities have not been adequately studied. The aim of this study was to compare the clinical outcomes of mini-open versus classic open surgery for one-level TLIF, with an individualized evaluation of the variables used for the clinical assessment.

Methods

A prospective cohort study was conducted of 41 individuals with degenerative disc disease who underwent a one-level TLIF from January 2007 to June 2008. Patients were randomized into two groups depending on the type of surgery performed: classic open (CL-TLIF) group and mini-open approach (MO-TLIF) group. The visual analog scale (VAS), North American Spine Society (NASS) Low Back Pain Outcome instrument, Oswestry Disability Index (ODI) and the Short Form 36 Health Survey (SF-36) were used for clinical assessment in a minimum 3-year follow-up (36–54 months).

Results

Patients of the MO-TLIF group presented lower rates of lumbar (p = 0.194) and sciatic pain (p = 0.427) and performed better in daily life activities, especially in those requiring mild efforts: lifting slight weights (p = 0.081), standing (p = 0.097), carrying groceries (p = 0.033), walking (p = 0.069) and dressing (p = 0.074). Nevertheless, the global scores of the clinical questionnaires showed no statistical differences between the CL-TLIF and the MO-TLIF groups.

Conclusions

Despite an improved functional status of MO-TLIF patients in the short term, the clinical outcomes of mini-open TLIF at the 3- to 4-year follow-up showed no clinically relevant differences to those obtained with open TLIF.

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Acknowledgments

The authors acknowledge the contribution of the members of the Spine Surgery Unit: Enrique Suñen, Diego Peña, Antonio Loste and Antonio Tabuenca, for their collaboration in this study.

Conflict of interest

None of the authors received any financial support or funding from any organization for this study. There are no conflicts of interest in this manuscript. The authors also state that they have full control of all primary data and that they allow the journal to review these data.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Traumatology, “Miguel Servet” University Hospital, Isabel La Católica s/n, 5009, Zaragoza, Spain

    Javier Rodríguez-Vela, Antonio Lobo-Escolar, Javier Muñoz-Marín & Antonio Herrera

  2. Aragón Health Sciences Institute, Zaragoza, Spain

    Antonio Lobo-Escolar & Antonio Herrera

  3. Department of Orthopaedic Surgery and Traumatology, Barbastro Hospital, Huesca, Spain

    Eduardo Joven

  4. Department of Internal Medicine, “Miguel Servet” University Hospital, Isabel La Católica s/n, 5009, Zaragoza, Spain

    José Velilla

  5. Department of Surgery, University of Zaragoza, Zaragoza, Spain

    Antonio Herrera

Authors
  1. Javier Rodríguez-Vela
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  2. Antonio Lobo-Escolar
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  3. Eduardo Joven
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  4. Javier Muñoz-Marín
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  5. Antonio Herrera
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  6. José Velilla
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Corresponding author

Correspondence to Antonio Lobo-Escolar.

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Rodríguez-Vela, J., Lobo-Escolar, A., Joven, E. et al. Clinical outcomes of minimally invasive versus open approach for one-level transforaminal lumbar interbody fusion at the 3- to 4-year follow-up. Eur Spine J 22, 2857–2863 (2013). https://doi.org/10.1007/s00586-013-2853-y

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  • DOI: https://doi.org/10.1007/s00586-013-2853-y

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