Skip to main content
Top
Published in: European Spine Journal 11/2012

01-11-2012 | Original Article

Minimally invasive transforaminal lumber interbody fusion and degenerative lumbar spine disease

Authors: Antonio Tsahtsarlis, Martin Wood

Published in: European Spine Journal | Issue 11/2012

Login to get access

Abstract

Objective

The purpose of this study was to assess the clinical and radiological outcomes of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) surgery for degenerative lumbar spine disease.

Methods

A prospective analysis of 34 consecutive patients who underwent a MI-TLIF using image guidance between July 2008 and November 2010. The patient group comprised 19 males and 15 females (mean age 56), 23 of whom had undergone additional reduction of spondylolisthesis. All patients underwent post-operative CT imaging to assess pedicle screw, cage placement and fusion at 6 months. Oswestry Disability Index (ODI) scores were recorded pre-operatively and at 6-month follow up.

Results

33/34 (97.1 %) patients showed evidence of fusion at 6 months with a mean improvement of 27 on ODI scores. The mean length of hospital stay was 4 days. The mean operative time was 173 min.

Complications observed

1/34 (2.9 %) suffered a pulmonary embolism and 1/34 (2.9 %) patients developed transient nerve root pain post-operatively. There were no occurrences of infection and no post-operative CSF leaks.

Conclusion

MI-TLIF offers patients a safe and effective surgical treatment option to treat degenerative lumbar spine disease.
Literature
1.
go back to reference Cloward RB (1953) The treatment of ruptured lumbar intervertebral discs by vertebral body fusion. I: indications, operative technique, after care. J Neurosurg 10:154–168PubMedCrossRef Cloward RB (1953) The treatment of ruptured lumbar intervertebral discs by vertebral body fusion. I: indications, operative technique, after care. J Neurosurg 10:154–168PubMedCrossRef
2.
go back to reference Harms J, Rolinger H (1982) A one-stage procedure in operative treatment of spondylolisthesis: dorsal traction-reposition and anterior fusion [in german]. Z Orthop Ihre Grenzgeb 120:343–347PubMedCrossRef Harms J, Rolinger H (1982) A one-stage procedure in operative treatment of spondylolisthesis: dorsal traction-reposition and anterior fusion [in german]. Z Orthop Ihre Grenzgeb 120:343–347PubMedCrossRef
3.
go back to reference Sethi A, Lee S, Vaidya R (2009) Transforaminal lumbar interbody fusion using unilateral pedicle screws and a translaminar screw. Eur Spine J 18(3):430–434PubMedCrossRef Sethi A, Lee S, Vaidya R (2009) Transforaminal lumbar interbody fusion using unilateral pedicle screws and a translaminar screw. Eur Spine J 18(3):430–434PubMedCrossRef
4.
go back to reference Grob D (2009) Surgery for degenerative lumbar disease: transforaminal lumbar interbody fusion. Eur Spine J 18(12):1991–1992PubMedCrossRef Grob D (2009) Surgery for degenerative lumbar disease: transforaminal lumbar interbody fusion. Eur Spine J 18(12):1991–1992PubMedCrossRef
5.
go back to reference Gejo R, Matsui H, Kawaguchi Y et al (1999) Serial changes in trunk muscle performance after posterior lumbar surgery. Spine 120:1023–1028CrossRef Gejo R, Matsui H, Kawaguchi Y et al (1999) Serial changes in trunk muscle performance after posterior lumbar surgery. Spine 120:1023–1028CrossRef
6.
go back to reference Rantanen J, Hurme M, Falck B et al (1993) The lumbar multifidus muscle five years after surgery for a lumbar intervertebral disc herniation. Spine 18:568–574PubMedCrossRef Rantanen J, Hurme M, Falck B et al (1993) The lumbar multifidus muscle five years after surgery for a lumbar intervertebral disc herniation. Spine 18:568–574PubMedCrossRef
7.
go back to reference Sihvonen T, Herno A, Paljiarvi L et al (1993) Local denervation atrophy of paraspinal muscles in post operative failed back syndrome. Spine 18:575–581PubMedCrossRef Sihvonen T, Herno A, Paljiarvi L et al (1993) Local denervation atrophy of paraspinal muscles in post operative failed back syndrome. Spine 18:575–581PubMedCrossRef
8.
go back to reference Styf JR, Willen J (1998) The effects of external compression by three different retractors on pressure in the erector spine muscles during and after posterior lumbar spine surgery in humans. Spine 23:354–358PubMedCrossRef Styf JR, Willen J (1998) The effects of external compression by three different retractors on pressure in the erector spine muscles during and after posterior lumbar spine surgery in humans. Spine 23:354–358PubMedCrossRef
9.
go back to reference Foley KT, Lefkowitz MA (2002) Advances in minimally invasive spine surgery. Clin Neurosurg 49:499–517PubMed Foley KT, Lefkowitz MA (2002) Advances in minimally invasive spine surgery. Clin Neurosurg 49:499–517PubMed
10.
go back to reference Molinari RW, Bridwell SJ, Klepps SJ et al (1999) Minimum 5 year follow up of anterior column structural allografts in the thoracic and lumbar spine. Spine 24:967–972PubMedCrossRef Molinari RW, Bridwell SJ, Klepps SJ et al (1999) Minimum 5 year follow up of anterior column structural allografts in the thoracic and lumbar spine. Spine 24:967–972PubMedCrossRef
11.
go back to reference Mannion R, Nowitzke A, Wood M (2010) Promoting fusion in minimally invasive lumbar interbody stabilisation with low dose BMP-2—but what is the cost? Spine J [E-pub prior to print] Mannion R, Nowitzke A, Wood M (2010) Promoting fusion in minimally invasive lumbar interbody stabilisation with low dose BMP-2—but what is the cost? Spine J [E-pub prior to print]
12.
go back to reference Park P, Foley KT (2008) Minimally invasive transforaminal lumbar interbody fusion with reduction of spondylolisthesis: technique and outcomes after a minimum of 2 years’ follow-up. Neurosurg Focus 25:E16PubMedCrossRef Park P, Foley KT (2008) Minimally invasive transforaminal lumbar interbody fusion with reduction of spondylolisthesis: technique and outcomes after a minimum of 2 years’ follow-up. Neurosurg Focus 25:E16PubMedCrossRef
13.
go back to reference Mura PP, Costaglioli M, Piredda M, Caboni S, Casula S (2011) TLIF for symptomatic disc degeneration: a retrospective study of 100 patients. Eur Spine J 20(Suppl 1):S57–S60PubMedCrossRef Mura PP, Costaglioli M, Piredda M, Caboni S, Casula S (2011) TLIF for symptomatic disc degeneration: a retrospective study of 100 patients. Eur Spine J 20(Suppl 1):S57–S60PubMedCrossRef
14.
go back to reference Faundez AA, Schwender JD, Safriel Y, Gilbert TJ, Mehbod AA, Denis F, Transfeldt EE, Wroblewski JM (2009) Clinical and radiological outcome of anterior-posterior fusion versus transforaminal lumbar interbody fusion for symptomatic disc degeneration: a retrospective comparative study of 133 patients. Eur Spine J 18(2):203–211PubMedCrossRef Faundez AA, Schwender JD, Safriel Y, Gilbert TJ, Mehbod AA, Denis F, Transfeldt EE, Wroblewski JM (2009) Clinical and radiological outcome of anterior-posterior fusion versus transforaminal lumbar interbody fusion for symptomatic disc degeneration: a retrospective comparative study of 133 patients. Eur Spine J 18(2):203–211PubMedCrossRef
15.
go back to reference Schwender JD, Holly LT, Rouben DP et al (2005) Minimally invasive transforaminal lumbar interbody fusion (TLIF): technical feasibility and initial results. J Spinal Disord Tech 18(suppl 1):S1–S6PubMedCrossRef Schwender JD, Holly LT, Rouben DP et al (2005) Minimally invasive transforaminal lumbar interbody fusion (TLIF): technical feasibility and initial results. J Spinal Disord Tech 18(suppl 1):S1–S6PubMedCrossRef
16.
go back to reference Schizas C, Tzinieris N, Tsiridis E et al (2009) Minimally invasive versus open transforaminal lumbar interbody fusion: evaluating initial experience. Int Orthop 33:1683–1688PubMedCrossRef Schizas C, Tzinieris N, Tsiridis E et al (2009) Minimally invasive versus open transforaminal lumbar interbody fusion: evaluating initial experience. Int Orthop 33:1683–1688PubMedCrossRef
17.
go back to reference Peng CW, Yue WM, Poh SY et al (2009) Clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion. Spine 34:1385–1389PubMedCrossRef Peng CW, Yue WM, Poh SY et al (2009) Clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion. Spine 34:1385–1389PubMedCrossRef
18.
go back to reference Villavicencio AT, Burneikiene S, Roeca CM et al (2010) Minimally invasive versus open transforaminal lumbar interbody fusion. Surg Neurol Int 1:12PubMedCrossRef Villavicencio AT, Burneikiene S, Roeca CM et al (2010) Minimally invasive versus open transforaminal lumbar interbody fusion. Surg Neurol Int 1:12PubMedCrossRef
19.
go back to reference Shunwu F, Xing Z, Fengdong Z et al (2010) Minimally invasive transforaminal lumbar interbody fusion for the treatment of degenerative lumbar diseases. Spine 35:1615–1620PubMedCrossRef Shunwu F, Xing Z, Fengdong Z et al (2010) Minimally invasive transforaminal lumbar interbody fusion for the treatment of degenerative lumbar diseases. Spine 35:1615–1620PubMedCrossRef
20.
go back to reference Wang J, Zhou Y, Zhang ZF, Li CQ, Zheng WJ, Liu J (2011) Minimally invasive or open transforaminal lumbar interbody fusion as revision surgery for patients previously treated by open discectomy and decompression of the lumbar spine. Eur Spine J 20(4):623–628PubMedCrossRef Wang J, Zhou Y, Zhang ZF, Li CQ, Zheng WJ, Liu J (2011) Minimally invasive or open transforaminal lumbar interbody fusion as revision surgery for patients previously treated by open discectomy and decompression of the lumbar spine. Eur Spine J 20(4):623–628PubMedCrossRef
21.
go back to reference Wang J, Zhou Y, Zheng Z et al (2010) Comparison of one-level minimally invasive and open transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2. Eur Spine J 19:1780–1784PubMedCrossRef Wang J, Zhou Y, Zheng Z et al (2010) Comparison of one-level minimally invasive and open transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2. Eur Spine J 19:1780–1784PubMedCrossRef
22.
go back to reference Dhall SS, Wang MY, Mummaneni PV (2008) Clinical and radiographic comparison of mini-open transforaminal lumbar interbody fusion with open transforaminal lumbar interbody fusion in 42 patients with long-term follow-up. Neurosurg Spine 9:560–565CrossRef Dhall SS, Wang MY, Mummaneni PV (2008) Clinical and radiographic comparison of mini-open transforaminal lumbar interbody fusion with open transforaminal lumbar interbody fusion in 42 patients with long-term follow-up. Neurosurg Spine 9:560–565CrossRef
23.
go back to reference Isaacs RE, Podichetty VK, Santiago P et al (2005) Minimally invasive microendoscopy-assisted transforaminal interbody fusion with instrumentation. J Neurosurg Spine 3:98–105PubMedCrossRef Isaacs RE, Podichetty VK, Santiago P et al (2005) Minimally invasive microendoscopy-assisted transforaminal interbody fusion with instrumentation. J Neurosurg Spine 3:98–105PubMedCrossRef
24.
go back to reference Karikari IO, Isaacs RE (2010) Minimally invasive transforminal lumbar interbody fusion: a review of techniques and outcomes. Spine 35:S294–S301PubMedCrossRef Karikari IO, Isaacs RE (2010) Minimally invasive transforminal lumbar interbody fusion: a review of techniques and outcomes. Spine 35:S294–S301PubMedCrossRef
25.
go back to reference Wu RH, Fraser JF, Hartl R (2010) Minimal access versus open transforaminal lumbar interbody fusion. Spine 35:2273–2281PubMedCrossRef Wu RH, Fraser JF, Hartl R (2010) Minimal access versus open transforaminal lumbar interbody fusion. Spine 35:2273–2281PubMedCrossRef
Metadata
Title
Minimally invasive transforaminal lumber interbody fusion and degenerative lumbar spine disease
Authors
Antonio Tsahtsarlis
Martin Wood
Publication date
01-11-2012
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 11/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-012-2376-y

Other articles of this Issue 11/2012

European Spine Journal 11/2012 Go to the issue

Review Article

Schmorl’s nodes