Comparison of Single-Level Open and Minimally Invasive Transforaminal Lumbar Interbody Fusions Presenting a Learning Curve

Abstract

Background: Comparison of single-level open and minimally invasive transforaminal lumbar interbody fusions (O-TLIF and MI-TLIF) of a single surgeon and presentation of his MI-TLIF learning curve in a retrospective observational cohort study.

Methods: 27 MI-TLIF and 31 O-TLIF patients, performed between 03/01/2013 and 03/31/2018, were compared regarding the operative time, blood loss, blood transfusion frequency, postoperative length of stay (LOS), and adverse events. An overall comparison of pre- and postoperative Oswestry Disability Index (ODI) results and Visual Analog Score (VAS) results of low back and leg pain was performed in the case of the two techniques. For a learning curve presentation, the MI-TLIF cases were compared and the optimal operative time was determined.

Results: The gender ratio and age did not differ in the groups. Operative time showed no difference (P=0.88) between the MI-TLIF (161.2 ± 33.7 minutes) and O-TLIF groups (160 ± 33.6 minutes). Intraoperative blood loss was less (P=0.88) between the MI-TLIF (161.2 ± 33.7 minutes) and O-TLIF groups (160 ± 33.6 minutes). Intraoperative blood loss was less (P=0.88) between the MI-TLIF (161.2 ± 33.7 minutes) and O-TLIF groups (160 ± 33.6 minutes). Intraoperative blood loss was less (P=0.88) between the MI-TLIF (161.2 ± 33.7 minutes) and O-TLIF groups (160 ± 33.6 minutes). Intraoperative blood loss was less (P=0.88) between the MI-TLIF (161.2 ± 33.7 minutes) and O-TLIF groups (160 ± 33.6 minutes). Intraoperative blood loss was less (P=0.88) between the MI-TLIF (161.2 ± 33.7 minutes) and O-TLIF groups (160 ± 33.6 minutes). Intraoperative blood loss was less (P=0.88) between the MI-TLIF (161.2 ± 33.7 minutes) and O-TLIF groups (160 ± 33.6 minutes). Intraoperative blood loss was less (P=0.88) between the MI-TLIF (161.2 ± 33.7 minutes) and O-TLIF groups (160 ± 33.6 minutes). Intraoperative blood loss was less (P=0.88) between the MI-TLIF (161.2 ± 33.7 minutes) and O-TLIF groups (160 ± 33.6 minutes). Intraoperative blood loss was less (P=0.88) between the MI-TLIF (161.2 ± 33.7 minutes) and O-TLIF groups (160 ± 33.6 minutes). Intraoperative blood loss was less (P=0.88) between the MI-TLIF (161.2 ± 33.7 minutes) and O-TLIF groups (160 ± 33.6 minutes). Intraoperative blood loss was less (p=0.88) between the MI-TLIF (161.2 ± 33.7 minutes) and O-TLIF groups (160 ± 33.6 minutes). Intraoperative blood loss was less (P=0.88) between the MI-TLIF (161.2 ± 33.7 minutes) and O-TLIF groups (160 ± 33.6 minutes). Intraoperative blood loss was less (P=0.88) between the MI-TLIF (161.2 ± 33.7 minutes) and O-TLIF groups (160 ± 33.6 minutes). Intraoperative blood loss was less (P=0.88) between the MI-TLIF (161.2 ± 33.7 minutes) and O-TLIF groups (160 ± 33.6 minutes). Intraoperative blood loss was less (P=0.88) between the MI-TLIF (161.2 ± 33.7 minutes) and O-TLIF groups (160 ± 33.6 minutes). Intraoperative blood loss was less (.

Conclusions: Similar operative time and postoperative quality of life improvement can be achieved by MI-TLIF procedure as with O-TLIF, and additionally LOS and blood loss can be reduced. When comparing parameters, MI-TLIF can be an alternative option for O-TLIF with a similar complication profile. The learning curve of MI-TLIF can be steep, although it depends on the circumstances.