Differences in the interbody bone graft area and fusion rate between minimally invasive and traditional open transforaminal lumbar interbody fusion: a retrospective short-term image analysis

2019 ◽  
Vol 28 (9) ◽  
pp. 2095-2102 ◽  
Author(s):  
Yu-Cheng Yao ◽  
Hsi-Hsien Lin ◽  
Po-Hsin Chou ◽  
Shih-Tien Wang ◽  
Ming-Chau Chang
Keyword(s):  
Image Analysis ◽  
Minimally Invasive ◽  
Bone Graft ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Lumbar Interbody Fusion ◽  
Short Term ◽  
Graft Area

Comparison of Clinical Outcomes and Complications Between Percutaneous Endoscopic and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Degenerative Lumbar Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 24 (6) ◽  
pp. 441-452
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Lumbar Interbody Fusion ◽  
Degenerative Lumbar Disease

BACKGROUND: Percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) has been increasingly used to treat degenerative lumbar disease in recent years. However, there are still controversies about whether PE-TLIF is superior to minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). OBJECTIVES: To compare clinical outcomes and complications of PE-TLIF and MIS-TLIF in treating degenerative lumbar disease. STUDY DESIGN: A systematic review and meta-analysis. METHODS: A comprehensive search of online databases including PubMed, Embase, and the Cochrane Library was performed to identify related studies reporting the outcomes and complications of PE-TLIF and MIS-TLIF for degenerative lumbar disease. The clinical outcomes were assessed by the Visual Analog Scale and Oswestry Disability Index. In addition, the operative time, intraoperative blood loss, time to ambulation, length of hospital stay, fusion rate, and surgery-related complications were summarized. Forest plots were constructed to investigate the results. RESULTS: A total of 28 studies involving 1,475 patients were included in this meta-analysis. PE-TLIF significantly reduced operative time, intraoperative blood loss, time to ambulation, and length of hospital stay compared to MIS-TLIF. Moreover, PE-TLIF was superior to MIS-TLIF in the early postoperative relief of back pain. However, there were no significant differences in medium to long-term clinical outcomes, fusion rate, and incidence of complications between PE-TLIF and MIS-TLIF. LIMITATIONS: The current evidence is heterogeneous and most studies included in this meta-analysis are nonrandomized controlled trials. CONCLUSIONS: The present meta-analysis indicates that medium to long-term clinical outcomes and complication rates of PE-TLIF were similar to MIS-TLIF for the treatment of degenerative lumbar disease. However, PE-TLIF shows advantages in less surgical trauma, faster recovery, and early postoperative relief of back pain. KEY WORDS: Percutaneous endoscopic transforaminal lumbar interbody fusion, minimally invasive transforaminal lumbar interbody fusion, degenerative lumbar disease, chronic pain, systematic review, meta-analysis

Iliac Crest Bone Graft for Minimally Invasive Transforaminal Lumbar Interbody Fusion

Spine ◽  
2018 ◽  
pp. 1 ◽  
Author(s):  
Brittany E. Haws ◽  
Benjamin Khechen ◽  
Ankur S. Narain ◽  
Fady Y. Hijji ◽  
Kaitlyn L. Cardinal ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Bone Graft ◽  
Interbody Fusion ◽  
Iliac Crest ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Iliac Crest Bone Graft ◽  
Lumbar Interbody Fusion

scholarly journals Outcome of Ti/PEEK Versus PEEK Cages in Minimally Invasive Transforaminal Lumbar Interbody Fusion

2021 ◽  
pp. 219256822110003
Author(s):  
Yu-Cheng Yao ◽  
Po-Hsin Chou ◽  
Hsi-Hsien Lin ◽  
Shih-Tien Wang ◽  
Ming-Chau Chang
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Lumbar Interbody Fusion ◽  
Peek Cage ◽  
Retrospective Case ◽  
Peek Composite ◽  
Cage Subsidence

Study Design: Retrospective case-control study. Objectives: This study aims to present the clinical and radiographical outcomes of the titanium-polyetheretherketone (Ti/PEEK) composite cage compared to those of the standard PEEK cage in patients receiving minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). Methods: Patients receiving 1 level MI-TLIF between October 2015 and October 2017 were included with a minimum of 2-year follow-up. The patients were segregated into 2 groups; Ti/PEEK group and PEEK group. Each patient was propensity-matched using preoperative age, sex, and body mass index. Early fusion rate was evaluated by computed tomography at postoperative 6 months. Clinical outcomes were assessed using the visual analog scale (VAS) and Oswestry Disability Index (ODI) scores. Results: After matching, there were 27 patients included in each group. The demographics, diagnosis, and surgical details were not significantly different between the 2 groups. The 6-month rate was 88.9% in Ti/PEEK group. The fusion rate and cage subsidence rate had no difference between the 2 groups. The complication rate in the Ti/PEEK group was comparable to that in the PEEK group. There was no difference in VAS and ODI scores during a 2-year follow-up period. Conclusions: The use of Ti/PEEK composite cage was as safe and effective as the use of PEEK cage in MI-TLIF. The 6-month fusion rate was 88.9%. Our finding revealed comparable clinical results for surgeons using Ti/PEEK composite cages in MI-TLIF compared to those using the PEEK cage.

Minimally Invasive Transforaminal Lumbar Interbody Fusion With Intraoperative Fluoroscopy for Disc Space Preparation: Analysis of Fusion Rate and Clinical Results

2020 ◽  
Vol 19 (5) ◽  
pp. 557-566
Author(s):  
Guang-Xun Lin ◽  
Sagar Sharma ◽  
Gang Rui ◽  
Myung-Soo Song ◽  
Jin-Sung Kim
Keyword(s):  
Minimally Invasive ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Lateral View ◽  
Lumbar Interbody Fusion ◽  
Disc Space ◽  
Intraoperative Fluoroscopy ◽  
Cage Subsidence

Abstract BACKGROUND Meticulous disc space preparation is an important step toward ensuring arthrodesis in the interbody fusion procedure. Although minimally invasive techniques are becoming increasingly advanced in lumbar interbody fusion, concerns exist regarding adequate discectomy and sufficient endplate preparation from a transforaminal lumbar approach. OBJECTIVE To describe the radiographic and clinical outcomes of single-level minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) using the intraoperative fluoroscopy-guided method for disc space preparation. METHODS This is a retrospective study of 25 patients operated between June 2016 and Dec 2017. The radiographic outcomes included the intraoperative percentage of disc space preparation, fusion, and subsidence. Percentage of disc space preparation was calculated through intraoperative fluoroscopic imaging. Clinical outcomes included visual analog scale (VAS), Oswestry Disability Index (ODI), and satisfaction rate. RESULTS Mean age of patients was 62.9 yr. The mean follow-up period was 22 mo. Mean extents of disc space preparation were 61.5% in the anteroposterior view and 80.3% in the lateral view. Fusion rates were 86% and 92% at 6 and 12-mo postoperatively, respectively. All patients showed clinical improvement according to VAS and ODI. CONCLUSION MI-TLIF with intraoperative fluoroscopy-guided disc space preparation is shown to lead to potentially improved fusion rate. It is a safe and effective surgical method for degenerative lumbar disease. Additionally, in cases of cage subsidence caused by the endplate violation during disc space preparation, thorough sufficient bone grafting of the defect region avoids pseudoarthrosis.

scholarly journals Unilateral pedicle screw instrumentation for minimally invasive transforaminal lumbar interbody fusion

2006 ◽  
Vol 20 (3) ◽  
pp. 1-5 ◽  
Author(s):  
Will F. Beringer ◽  
Jean-Pierre Mobasser
Keyword(s):  
Minimally Invasive ◽  
Pedicle Screw ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Clinical Results ◽  
Fusion Rate ◽  
Lumbar Interbody Fusion ◽  
Pedicle Screw Instrumentation ◽  
Percutaneous Pedicle Screw ◽  
Unilateral Pedicle Screw

Object Clinical and radiographic results were assessed to determine the clinical outcomes and fusion rate in eight consecutive patients selected for minimally invasive transforaminal lumbar interbody fusion (TLIF) in which a percutaneous pedicle screw system was used unilaterally. Methods Eight patients underwent one-level, minimally invasive TLIF in which a percutaneous pedicle screw system was used only on the side where facets were removed for interbody access. Clinical, economic, functional, and radiographic data were recorded preoperatively and at 6 months postoperatively. The mean 6-month change in the modified Prolo Scale score was 7, and osseous interbody bridging assessed on coronal and sagittal computerized tomography studies was seen in all patients. Conclusions The use of unilateral percutaneous pedicle screw instrumentation for the minimally invasive TLIF procedure provides excellent clinical results and is an option in selected patients.

scholarly journals Endoscopic Versus Minimally Invasive Transforaminal Lumbar Interbody Fusion In 1-Segment Lumbar Spondylolisthesis: A Prospective Randomised Pilot Study

2021 ◽  
Author(s):  
You Lv ◽  
Ming Chen ◽  
Ru-Jie Qin ◽  
Cheng Ma ◽  
Qi-Rui Ding ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Lumbar Interbody Fusion ◽  
Trial Registry ◽  
Clinical Trial Registry ◽  
Multifidus Muscle ◽  
Lumbar Spondylolisthesis

Abstract Background: There are currently several minimally invasive techniques for lumbar spine interbody fusion that have been shown to minimize surgical and perioperative morbidity. We aimed to evaluate the curative efficacy of endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) by comparing perioperative characteristics and 1.5-year observational outcomes in 1-segment lumbar spondylolisthesis between the minimally invasive TLIF (MIS-TLIF) technique and the optimized Endo-TLIF technique. Methods: One hundred and two patients treated by MIS-TLIF (48 cases) or Endo-TLIF (54 cases) were included from March 2018 to April 2019. Perioperative parameters and clinical outcomes were evaluated. Inflammatory biomarkers were measured for postoperative traumatic stress and muscle injury. Fusion rates were determined at 18 months after surgery by CT.Results: The Endo-TLIF group had similar incision length, return to work time and rate (p>0.05). Blood loss, left bed time and analgesic ratio were significantly less in Endo-TLIF group (p<0.05). The Endo-TLIF group had a significantly longer operative and radiation exposure time compared with MIS-TLIF group (p<0.05). The CRP and ESR levels were lower in the Endo-TLIF group compared with the MIS-TLIF group (p<0.05). The VAS and ODI improved significantly in both groups after surgery. Significant decreases in low back VAS in the Endo-TLIF group were found at postoperative day 1 and 3 months after surgery (p<0.05). The fusion rate in the Endo-TLIF group (90.7%) was similar to that in the MIS-TLIF group (95.8%).Conclusions: Endo-TLIF has comparable perioperative analysis and clinical outcomes in comparison to MIS-TLIF and manifests a greater improvement in less multifidus muscle damage, inflammation and faster patient recovery. Thus, Endo-TLIF should be considered as a feasible and effective technique for 1-segment lumbar spondylolisthesis patients with similar fusion rate.Trial registration: ChiCTR1800015197, 13 March 2018. Trial registry: Chinese Clinical Trial Registry. Registered 13 March 2018. http://www.chictr.org.cn/showproj.aspx?proj=25865

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