Minimally Invasive Posterior Lumbar Interbody Fusion: Comparison with Traditional Open Surgery

Park, Yung; Ha, Joong Won; Sung, Seung Yong; Oh, Hyun Cheol; Yoo, Ju Hyung; Lee, Yun Tae

Abstract

PURPOSE: To compare the the clinical and radiographic results of the two approaches for posterior lumbar fusion, one-level posterior lumbar interbody fusion (PLIF) performed with a minimally invasive approach or the traditional open approach.
MATERIALS AND METHODS
This study examined a consecutive series of 46 patients who underwent one-level PLIF procedure (27 cases performed with minimally invasive approach and 19 cases with traditional open approach) by one surgeon at one hospital. The following data were compared with a minimum 1-year follow-up: the clinical and radiographic results, surgical time, estimated blood loss, transfusion requirements, postoperative back pain, time needed before ambulation, length of hospital stay, and complications.
RESULTS
There was no statistical difference between the two groups in terms of the clinical and radiographic results at the last follow-up. The minimally invasive group was found to have a less blood loss, fewer transfusion requirements, less postoperative back pain, a shorter recovery time, and a shorter hospital stay. However, minimally invasive group required a longer surgical time and there were 2 cases with technical complications.
CONCLUSION
This study confirmed the favorable results reported by previous uncontrolled cohort studies. It also showed that the minimally invasive approach had a similar surgical efficacy to that of traditional open approach. However, minimally invasive technique requires a steep learning curve and attention in order to lower the risk of complications.