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Prospective Comparative Study of Clinical and Radiological Outcome of Open versus Minimal Invasive Transforaminal Lumbar Interbody Fusion in Degenerative Lumbar Spine Disease

Vol. 9 | Issue 1 | January-February 2021 | Page: 08-13 | Mohan N S, Vijay Vithal Mundewadi, H S Chandrashekar


Authors: Mohan N S [1], Vijay Vithal Mundewadi [1], H S Chandrashekar [1]

[1] Department of Orthopaedics, Sanjay Gandhi Institute of Trauma And Orthopaedics, Byrasandra, Jayanagar East, Bengaluru, Karnataka, India.

Address of Correspondence
Dr. Vijay V. Mundewadi,
Junior Resident, Department of Orthopaedics, Sanjay
Gandhi Institute of Trauma And Orthopaedics,
Bengaluru, Karnataka, India.
E-mail: vijayvithalmundewadi@gmail.com

 


Abstract


Objectives: Clinical outcome of degenerative lumbar spine disease treated by minimal invasive and open TLIF assessed by visual analog score and Oswestry Disability Index and to compare radiological outcome by Bridwell interbody fusion grading, Cobb’s angle and to compare intraoperative blood loss, length of hospital stay, and duration of surgery between the two groups.
Materials and Methods: A prospective comparative study of 50 patients with degenerative lumbar spine disease with Grade I spinal canal stenosis, spondylolisthesis Grades II and III were treated with minimal invasive TLIF and open TLIF at the Department of Spine Surgery, Sanjay Gandhi Institute of Trauma and Orthopaedic, Bengaluru, from June 2019 to June 2020. Clinical assessment was done with VAS and ODI score system and radiological assessment was done with Cobb’s angle, Bridwell interbody fusion grading system. Patients were divided into two groups according to the surgical method used. In Group A, 25 patients underwent minimal invasive TLIF M. In Group B, 25 patients underwent open TLIF. Clinical and radiological parameters were evaluated before surgery, after surgery, 3 months, 6 months, and 1 year after surgery.
Results: Our study had predominant female population. Predominant age group was 45–55 years, who had degenerative lumbar spine disease. The most common degenerative disease was spondylolisthesis. Majority of the patients had L4–L5 level involvement. VAS at the end of 12 months was 1.6 and 2.5 for M–TLIF and O–TLIF, respectively. ODI scores at the end of 12 months where 13.8 and 19.2, respectively, for M–TLIF and O–TLIF. Average hospital stay was 5.4 and eight, respectively, for minimally invasive transforaminal lumbar interbody fusion (M-TLIF) and open TLIF (O-TLIF). M-TLIF had less blood loss then O-TLIF. There was no statistical difference in the Bridwell fusion grading between the two groups.
Conclusion: M-TLIF provides patients a safe option for lumbar fusion, and the technique is comparable to open TLIF with similar operating time, equivalent clinical and radiological outcomes, and comparable complication rates. In addition, M-TLIF patients do have significant advantages over open TLIF patients in terms of perioperative outcomes, such as less blood loss and pain, earlier ambulation, and discharge from hospital.
Keywords: Degenerative lumbar spine disease, Open transforaminal lumbar interbody fusion, Minimally invasive transforaminal lumbar interbody fusion, Spondylolisthesis, Spinal canal stenosis.

 


References


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How to Cite this article: Mohan NS, Mundewadi VV, Chandrashekar HS | Prospective Comparative Study of Clinical and Radiological Outcome of Open versus Minimal Invasive Transforaminal Lumbar Interbody Fusion in Degenerative Lumbar Spine Disease | Journal of Karnataka Orthopaedic Association | January-February 2021; 9(1): 08-13.

 


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