scholarly journals Erratum to: “Enhanced Recovery After Surgery™ Awake Minimally-Invasive Transforaminal Lumbar Interbody Fusion: 2-Dimensional Operative Video” by Hsuan-Kan Chang et al. Operative Neurosurgery 2018; doi: 10.1093/ons/opy187

2018 ◽  
Vol 15 (5) ◽  
pp. 610-610
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Operative Neurosurgery

Enhanced Recovery After Surgery™ Awake Minimally-Invasive Transforaminal Lumbar Interbody Fusion: 2-Dimensional Operative Video

2018 ◽  
Vol 16 (4) ◽  
pp. 519-519 ◽  
Author(s):  
Hsuan-Kan Chang ◽  
John Paul G Kolcun ◽  
Peng-Yuan Chang ◽  
Michael Y Wang
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Hospital Costs ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Bone Morphogenetic Protein 2 ◽  
Ethical Standards ◽  
Lumbar Interbody Fusion ◽  
Research Committee

Abstract This video demonstrates the awake endoscopic minimally-invasive transforaminal lumbar interbody fusion (MIS-TLIF) used in our institution's developing Enhanced Recovery After Surgery program. This technique relies on 6 key components, including (1) conscious sedation, (2) endoscopic visualization, (3) long-acting local anesthesia, (4) an expandable interbody device, (5) osteobiologics, and (6) percutaneous instrumentation. In joining these technologies, this procedure embodies the principles of minimally invasive surgery while achieving excellent clinical outcomes. We have previously described this procedure in detail, as well as its impact at our institution, including significant reductions in operative time, blood loss, postoperative length of stay, and hospital costs. The procedure depicted in this video involves the off-label use of bone morphogenetic protein-2 and the Spineology Optimesh allograft containment device. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The patient gave direct consent for the use of the video footage and associated information from this surgery for the making and publication of this surgical video.

scholarly journals Clinical results of percutaneous biportal endoscopic lumbar interbody fusion with application of enhanced recovery after surgery

2019 ◽  
Vol 46 (4) ◽  
pp. E18 ◽  
Author(s):  
Dong Hwa Heo ◽  
Choon Keun Park
Keyword(s):  
Interbody Fusion ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Clinical Results ◽  
Fusion Rate ◽  
Lumbar Interbody Fusion ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
The Mean

OBJECTIVEThe aims of enhanced recovery after surgery (ERAS) are to improve surgical outcomes, shorten hospital stays, and reduce complications. The objective of this study was to introduce ERAS with biportal endoscopic transforaminal lumbar interbody fusion (TLIF) and to investigate the clinical results.METHODSPatients were divided into two groups based on the fusion procedures. Patients who received microscopic TLIF without ERAS were classified as the non-ERAS group, whereas those who received percutaneous biportal endoscopic TLIF with ERAS were classified as the ERAS group. The mean Oswestry Disability Index (ODI) and visual analog scale (VAS) scores were compared between the two groups. In addition, demographic characteristics, diagnosis, mean operative time, estimated blood loss (EBL), fusion rate, readmissions, and complications were investigated and compared.RESULTSForty-six patients were grouped into the non-ERAS group (microscopic TLIF without ERAS) and 23 patients into the ERAS group (biportal endoscopic TLIF with ERAS). The VAS score for preoperative back pain on days 1 and 2 was significantly higher in the non-ERAS group than in the ERAS group (p < 0.05). The mean operative duration was significantly higher in the ERAS group than in the non-ERAS group, while the mean EBL was significantly lower in the ERAS group than in the non-ERAS group (p < 0.05). There was no significant difference in fusion rate between the two groups (p > 0.05). Readmission was required in 2 patients who were from the non-ERAS group. Postoperative complications occurred in 6 cases in the non-ERAS group and in 2 cases in the ERAS group.CONCLUSIONSPercutaneous biportal endoscopic TLIF with an ERAS pathway may have good aspects in reducing bleeding and postoperative pain. Endoscopic fusion surgery along with the ERAS concept may help to accelerate recovery after surgery.

scholarly journals The Effect of Oblique Lumbar Interbody Fusion Compared with Transforaminal Lumbar Interbody Fusion Combined with Enhanced Recovery after Surgery Program on Patients with Lumbar Degenerative Disease at Short-Term Follow-Up

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Wenxiang Chen ◽  
Huiying Yang ◽  
Xuesheng Jiang ◽  
Shunwu Fan
Keyword(s):  
Interbody Fusion ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Therapeutic Effects ◽  
Reference Ranges ◽  
Lumbar Interbody Fusion ◽  
Short Term ◽  
Oblique Lumbar Interbody Fusion

Purpose. Oblique lumbar interbody fusion (OLIF) approach has been increasingly frequently performed in recent years. However, neither studies of OLIF approach nor the researches of the application of enhanced recovery after surgery (ERAS) in spinal surgery are relatively rare. Here, our study is aimed at investigating the therapeutic effects of the application of OLIF compared with transforaminal lumbar interbody fusion (TLIF) approach combined with ERAS in dealing with this disorder at short-term follow-up. Material and Methods. Thirty-eight patients who undergone OLIF and forty patients who undergone TLIF with pedicle screws were included in our study. The concept of ERAS was applied in the perioperative period of the patients. Preoperative and postoperative laboratory test indexes of blood were examined and evaluated in all individuals. Visual analogue scale (VAS), Oswestry disability index (ODI), and Clinical Symptom Score of the Japanese Orthopaedic Association (JOA) were used in preoperative evaluation and postoperative follow-up. Satisfaction survey was also performed after surgery. Result. The postoperative results of red blood count, C-reaction protein, D-dimer, and albumin were still within the reference ranges in most of the patients. It was shown that objective evaluations including VAS score, ODI index, and JOA score were significantly improved after OLIF and TLIF surgery. The follow-up of 6 months after surgery showed that VAS, ODI, and JOA were improved more in the OLIF group than that in the TLIF group. The overall satisfaction (satisfied and very satisfied) was 95% and 97.4% in the TLIF group and the OLIF group, respectively, and there was no difference between the two groups. Conclusion. This study indicated that OLIF and TLIF approach were both rather effective therapies for patients with lumbar degenerative diseases. The effect of OLIF procedure could be better than TLIF procedure in the early stage after surgery.

Cost-effectiveness of minimally invasive midline lumbar interbody fusion versus traditional open transforaminal lumbar interbody fusion

2020 ◽  
Vol 32 (1) ◽  
pp. 31-35
Author(s):  
Mladen Djurasovic ◽  
Jeffrey L. Gum ◽  
Charles H. Crawford ◽  
Kirk Owens ◽  
Morgan Brown ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Minimally Invasive ◽  
Interbody Fusion ◽  
Smoking Status ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Direct Costs ◽  
Lumbar Interbody Fusion ◽  
Related Quality ◽  
Health Related

OBJECTIVEThe midline transforaminal lumbar interbody fusion (MIDLIF) using cortical screw fixation is a novel, minimally invasive procedure that may offer enhanced recovery over traditional open transforaminal lumbar interbody fusion (TLIF). Little information is available regarding the comparative cost-effectiveness of the MIDLIF over conventional TLIF. The purpose of this study was to compare cost-effectiveness of minimally invasive MIDLIF with open TLIF.METHODSFrom a prospective, multisurgeon, surgical database, a consecutive series of patients undergoing 1- or 2-level MIDLIF for degenerative lumbar conditions was identified and propensity matched to patients undergoing TLIF based on age, sex, smoking status, BMI, diagnosis, American Society of Anesthesiologists Physical Status Classification System (ASA) class, and levels fused. Direct costs at 1 year were collected, including costs associated with the index surgical visit as well as costs associated with readmission. Improvement in health-related quality of life was measured using EQ-5D and SF-6D.RESULTSOf 214 and 181 patients undergoing MIDLIF and TLIF, respectively, 33 cases in each cohort were successfully propensity matched. Consistent with propensity matching, there was no difference in age, sex, BMI, diagnosis, ASA class, smoking status, or levels fused. Spondylolisthesis was the most common indication for surgery in both cohorts. Variable direct costs at 1 year were $2493 lower in the MIDLIF group than in the open TLIF group (mean $15,867 vs $17,612, p = 0.073). There was no difference in implant (p = 0.193) or biologics (p = 0.145) cost, but blood utilization (p = 0.015), operating room supplies (p < 0.001), hospital room and board (p < 0.001), pharmacy (p = 0.010), laboratory (p = 0.004), and physical therapy (p = 0.009) costs were all significantly lower in the MIDLIF group. Additionally, the mean length of stay was decreased for MIDLIF as well (3.21 vs 4.02 days, p = 0.05). The EQ-5D gain at 1 year was 0.156 for MIDLIF and 0.141 for open TLIF (p = 0.821). The SF-6D gain at 1 year was 0.071 for MIDLIF and 0.057 for open TLIF (p = 0.551).CONCLUSIONSCompared with patients undergoing traditional open TLIF, those undergoing MIDLIF have similar 1-year gains in health-related quality of life, with total direct costs that are $2493 lower. Although the findings were not statistically significant, minimally invasive MIDLIF showed improved cost-effectiveness at 1 year compared with open TLIF.

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