Comparative study between "Traditional Open" versus "Less Invasive" Transforaminal lumbar Interbody Fusion in the treatment of Degenerative Lumbar Disc Disease

Document Type : Original Article

Authors

1 Orthopaedic dept., Minia University Hospital

2 Professor of Orthopedic Surgery & Traumatology Faculty of Medicine -Minia University

3 Assistant Professor of Orthopedic Surgery & Traumatology Faculty of Medicine -Minia University

Abstract

Purpose The object of this study was to compare minimally

invasive surgery (MIS) with open surgery in a

severely affected subgroup of degenerative spondylolisthetic

patients with severe stenosis (SDS) and high-grade

facet osteoarthritis (FJO).

Methods30

patients with severe SDS and high-grade FJO were treated

using either MIS or open TLIF. Intraoperative and diagnostic

data, including perioperative complications and

length of hospital stay (LOS), were collected, using retrospective

chart review. Surgical short- and long-term outcomes

were assessed according to the Oswestry disability

index (ODI) and visual analog scale (VAS) for back and

leg pain.

Results Comparing MIS and open surgery, the MIS group

had lesser blood loss, significantly lesser need for transfusion

(p = 0.02), more rapid improvement of postoperative

back pain in the first 6 weeks of follow-up and a

shorter LOS. On the other hand, we experienced in the MIS

group a longer operative time. The distribution on the

postoperative ODI (p = 0.841), VAS leg (p = 0.943) and

back pain (p = 0.735) scores after a mean follow-up of

2 years were similar. The overall proportion of complications

showed no significant difference between the groups

(29 % in the MIS group vs. 28 % in the open group,

p = 0.999).

Conclusion Minimally invasive surgery for severe SDS

leads to adequate and safe decompression of lumbar stenosis

and results in a faster recovery of symptoms and

disability in the early postoperative period.

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