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A novel mini-open transforaminal lumbar interbody fusion for lumbar degenerative diseases: technical note and preliminary results – Lumbar Fusion

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The article discusses a new modified open transforaminal lumbar interbody fusion (TLIF) procedure called mini-open TLIF, which involves the use of percutaneous pedicle screws. The study conducted a prospective analysis of 96 patients with degenerative lumbar spine diseases who underwent the mini-open TLIF procedure. The results showed that the operation time for single-level and multilevel procedures was relatively short, and there was minimal blood loss. The patients experienced significant improvement in pain and disability scores after surgery. Additionally, there was no significant difference in the cross-sectional area of paraspinal muscles before and after the operation and the atrophy rate. The study concludes that mini-open TLIF is an effective and feasible treatment option for degenerative lumbar diseases, particularly in multilevel cases, with minimal muscle damage and shorter operation times

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

CONCLUSION: Mini-open TLIF is effective and feasible for the treatment of lumbar degenerative diseases especially in multilevel disease, with minor damage to muscle and shorter operation time.

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J Orthop Surg Res. 2023 Jul 20;18(1):517. doi: 10.1186/s13018-023-04018-7.ABSTRACTBACKGROUND: Transforaminal lumbar interbody fusion (TLIF) is an effective and popular surgical procedure for the management of various spinal pathologies, especially degenerative diseases. Surgeons have been pursuing minimally invasive technology as soon as TLIF was appeared. Currently, TLIF can be performed with transforaminal approaches by open surgery,

J Orthop Surg Res. 2023 Jul 20;18(1):517. doi: 10.1186/s13018-023-04018-7.

ABSTRACT

BACKGROUND: Transforaminal lumbar interbody fusion (TLIF) is an effective and popular surgical procedure for the management of various spinal pathologies, especially degenerative diseases. Surgeons have been pursuing minimally invasive technology as soon as TLIF was appeared. Currently, TLIF can be performed with transforaminal approaches by open surgery, minimally invasive surgery or percutaneous endoscope. We provide a detailed description of a new modified open TLIF with percutaneous pedicle screws, which we refer to as mini-open TLIF. The objective of this study was to present feasibility of this procedure and the preliminary results.

METHODS: The study is a prospective study. From January 2021 to March 2022, 96 patients (43 males and 53 females) with neurological symptoms due to degenerative lumbar spine diseases were enrolled. Operation time, blood loss, ambulatory time, hematocrit and complications were recorded during perioperative period. Clinical symptoms were evaluated 1 week, 3 months and 12 months after surgery. Visual analogue scale (VAS) scores for lower back pain and leg pain and Oswestry disability index (ODI) were assessed. Magnetic resonance imaging was performed preoperatively and 12 months postoperatively to emulate cross-sectional area of paraspinal muscles. The lumbar interbody fusion rate was evaluated by CT scanning.

RESULTS: The mean operation time of single level was 112.6 min, and the mean operation time of multilevel was 140.1 min. Intraoperative blood loss of single level was 64.5 ml and was 116.3 ml of multilevel. The VAS and ODI scores before and after surgery were significantly different (P < 0.0001) and reached minimal clinically important difference. Atrophy rate of paraspinal muscles was 2.5% for symptomatic side and 1.2% for asymptomatic side. The cross-sectional area before and after the operation and atrophy rate had no statistically significant difference (P > 0.05).

CONCLUSION: Mini-open TLIF is effective and feasible for the treatment of lumbar degenerative diseases especially in multilevel disease, with minor damage to muscle and shorter operation time.

TRIAL REGISTRATION: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Second Affiliated Hospital of Soochow University (No. JD-LK2023045-I01).

PMID:37475005 | DOI:10.1186/s13018-023-04018-7

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A novel mini-open transforaminal lumbar interbody fusion for lumbar degenerative diseases: technical note and preliminary results

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J Orthop Surg Res. 2023 Jul 20;18(1):517. doi: 10.1186/s13018-023-04018-7.ABSTRACTBACKGROUND: Transforaminal lumbar interbody fusion (TLIF) is an effective and popular surgical procedure for the management of various spinal pathologies, especially degenerative diseases. Surgeons have been pursuing minimally invasive technology as soon as TLIF was appeared. Currently, TLIF can be performed with transforaminal approaches by open surgery

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