scholarly journals Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Disorders: Mini-open TLIF and Corrective TLIF

2015 ◽  
Vol 55 (7) ◽  
pp. 547-556 ◽  
Author(s):  
Masahito HARA ◽  
Yusuke NISHIMURA ◽  
Yasuhiro NAKAJIMA ◽  
Daisuke UMEBAYASHI ◽  
Masaya TAKEMOTO ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Degenerative Disorders ◽  
Mini Open

Nerve root anomalies: implications for transforaminal lumbar interbody fusion surgery and a review of the Neidre and Macnab classification system

2013 ◽  
Vol 35 (2) ◽  
pp. E9 ◽  
Author(s):  
Shane M. Burke ◽  
Mina G. Safain ◽  
James Kryzanski ◽  
Ron I. Riesenburger
Keyword(s):  
Nerve Root ◽  
Classification System ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Radicular Pain ◽  
Neurogenic Claudication ◽  
Lumbar Interbody Fusion ◽  
Lumbar Nerve Root ◽  
History Of ◽  
Mini Open

Lumbar nerve root anomalies are uncommon phenomena that must be recognized to avoid neural injury during surgery. The authors describe 2 cases of nerve root anomalies encountered during mini-open transforaminal lumbar interbody fusion (TLIF) surgery. One anomaly was a confluent variant not previously classified; the authors suggest that this variant be reflected in an amendment to the Neidre and Macnab classification system. They also propose strategies for identifying these anomalies and avoiding injury to anomalous nerve roots during TLIF surgery. Case 1 involved a 68-year-old woman with a 2-year history of neurogenic claudication. An MR image demonstrated L4–5 stenosis and spondylolisthesis and an L-4 nerve root that appeared unusually low in the neural foramen. During a mini-open TLIF procedure, a nerve root anomaly was seen. Six months after surgery this patient was free of neurogenic claudication. Case 2 involved a 60-year-old woman with a 1-year history of left L-4 radicular pain. Both MR and CT images demonstrated severe left L-4 foraminal stenosis and focal scoliosis. Before surgery, a nerve root anomaly was not detected, but during a unilateral mini-open TLIF procedure, a confluent nerve root was identified. Two years after surgery, this patient was free of radicular pain.

Clinical and radiographic comparison of mini–open transforaminal lumbar interbody fusion with open transforaminal lumbar interbody fusion in 42 patients with long-term follow-up

2008 ◽  
Vol 9 (6) ◽  
pp. 560-565 ◽  
Author(s):  
Sanjay S. Dhall ◽  
Michael Y. Wang ◽  
Praveen V. Mummaneni
Keyword(s):  
Blood Loss ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Open Group ◽  
Lumbar Interbody Fusion ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
The Mean ◽  
Mini Open

Object As minimally invasive approaches gain popularity in spine surgery, clinical outcomes and effectiveness of mini–open transforaminal lumbar interbody fusion (TLIF) compared with traditional open TLIF have yet to be established. The authors retrospectively compared the outcomes of patients who underwent mini–open TLIF with those who underwent open TLIF. Methods Between 2003 and 2006, 42 patients underwent TLIF for degenerative disc disease or spondylolisthesis; 21 patients underwent mini–open TLIF and 21 patients underwent open TLIF. The mean age in each group was 53 years, and there was no statistically significant difference in age between the groups (p = 0.98). Data were collected perioperatively. In addition, complications, length of stay (LOS), fusion rate, and modified Prolo Scale (mPS) scores were recorded at routine intervals. Results No patient was lost to follow-up. The mean follow-up was 24 months for the mini-open group and 34 months for the open group. The mean estimated blood loss was 194 ml for the mini-open group and 505 ml for the open group (p < 0.01). The mean LOS was 3 days for the mini-open group and 5.5 days for the open group (p < 0.01). The mean mPS score improved from 11 to 19 in the mini-open group and from 10 to 18 in the open group; there was no statistically significant difference in mPS score improvement between the groups (p = 0.19). In the mini-open group there were 2 cases of transient L-5 sensory loss, 1 case of a misplaced screw that required revision, and 1 case of cage migration that required revision. In the open group there was 1 case of radiculitis as well as 1 case of a misplaced screw that required revision. One patient in the mini-open group developed a pseudarthrosis that required reoperation, and all patients in the open group exhibited fusion. Conclusions Mini–open TLIF is a viable alternative to traditional open TLIF with significantly reduced estimated blood loss and LOS. However, the authors found a higher incidence of hardware-associated complications with the mini–open TLIF.

Single-level instrumented mini-open transforaminal lumbar interbody fusion in elderly patients

2008 ◽  
Vol 9 (2) ◽  
pp. 137-144 ◽  
Author(s):  
Dong Yeob Lee ◽  
Tag-Geun Jung ◽  
Sang-Ho Lee
Keyword(s):  
Elderly Patients ◽  
Interbody Fusion ◽  
Clinical Success ◽  
Degenerative Spondylolisthesis ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Adjacent Segment ◽  
Lumbar Interbody Fusion ◽  
Single Level ◽  
The Mean ◽  
Mini Open

Object The purpose of this study was to analyze the surgical outcomes in cases involving elderly patients who underwent single-level instrumented mini-open transforaminal lumbar interbody fusion (TLIF). Methods The authors performed a retrospective review of 27 consecutive cases involving elderly patients (≥ 65 years of age) who underwent single-level instrumented mini-open TLIF and were followed up for at least 3 years. Degenerative spondylolisthesis was diagnosed in 16 patients, stenosis with instability in 8, and lytic spondylolisthesis in 3. All cases were Grade I or II based on the American Society of Anesthesiologists' classification system. Clinical outcomes were assessed using a visual analog scale, the Oswestry Disability Index, and patients' subjective satisfaction. Sagittal balance, bone union, and adjacent segment degeneration (ASD) were assessed using plain radiography and 3D CT. Results The mean age of patients at the time of surgery was 69.3 years (range 65–80 years). Minor complications occurred in 2 patients (7.4%) in the perioperative period. At a mean follow-up duration of 38.6 months (range 36–42 months), clinical success was achieved in 88.9% of cases. The mean segmental lordosis and sacral tilt significantly increased after surgery (from 11.9 and 33.5° to 13.9 and 37.2°, p = 0.024 and p = 0.001, respectively). Solid fusion was achieved in 77.8% of the patients. Adjacent segment deterioration was found in 44.4% of the patients. No patients underwent revision surgery due to nonunion or ASD. The development of ASD was significantly related to postoperative sacral tilt (p = 0.006). Conclusions Single-level instrumented mini-open TLIF yielded good clinical and radiological outcomes with a low complication rate in elderly patients.

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