Perioperative safety and alignment outcomes in minimally invasive versus open transforaminal lumbar interbody fusion: A retrospective cohort study.

BACKGROUND

Transforaminal lumbar interbody fusion (TLIF) is a common procedure for degenerative lumbar disorders. Minimally invasive (MI) techniques were introduced to reduce perioperative morbidity versus open procedures. Here, we compared the perioperative characteristics, radiographic outcomes, and long-term complications for 1-level MI versus open TLIF.

METHODS

Retrospectively, 62 adults underwent single-level open versus MI TLIF at a tertiary academic (2021- 2024). Clinical, radiographic, and outcome data were collected, along with the evaluation of other variables: operative time, blood loss, hospital stay, adverse events, adjacent segment disease (ASD), and radiographic correction of lordosis.

RESULTS

MI TLIF resulted in shorter hospital stays (length of stay [LOS]) (4.1 vs. 7.7 days), reduced estimated blood loss (EBL) (51.5 vs. 185.1 mL), less drain use, but similar fusion and reoperation rates. Open TLIF resulted in more durotomies (18.8% vs. 0%), a higher rate of ASD (50.0% vs. 23.03%), but greater global and segmental lordosis correction. Notably, functional outcome and symptom improvement remained similar between the two groups.

CONCLUSION

Patients undergoing single-level MI TLIF exhibited shorter LOS, reduced EBL, recoveries, and reduced ASD risk, while those undergoing open TLIF exhibited better postoperative global/sagittal alignment correction. Notably, both groups exhibited comparable functional outcomes.