Early benefits of minimally invasive transforaminal lumbar interbody fusion in comparison with the traditional open procedure

  • Gregor Rečnik *Univerzitetni klinični center Maribor, Oddelek za ortopedijo, Ljubljanska ulica 5, 2000 Maribor
  • Milko Milčič *Univerzitetni klinični center Maribor, Oddelek za ortopedijo, Ljubljanska ulica 5, 2000 Maribor
  • Samo Karl Fokter *Univerzitetni klinični center Maribor, Oddelek za ortopedijo, Ljubljanska ulica 5, 2000 Maribor izr. prof.
  • Nino Mirnik *Univerzitetni klinični center Maribor, Oddelek za ortopedijo, Ljubljanska ulica 5, 2000 Maribor
  • Andrej Moličnik *Univerzitetni klinični center Maribor, Oddelek za ortopedijo, Ljubljanska ulica 5, 2000 Maribor asist.
  • Matjaž Vogrin *Univerzitetni klinični center Maribor, Oddelek za ortopedijo, Ljubljanska ulica 5, 2000 Maribor doc. dr.
Keywords: spondylodesis, TLIF, spinal fusion, multifidus muscle

Abstract

Abstract

Background

Lumbar interbody fusion is a standard operative procedure in orthopedic spine surgery. Morphological and functional changes in the multifidus muscle after an open procedure have led to the development of a minimally invasive technique, after which no such muscle changes were observed.

Methods

Sixty-four patients, with clinical and radiological criteria for one-level transforaminal lumbar interbody fusion were enrolled in our prospective randomized study between December 2011 and March 2014. They were randomized into two groups: open approach (33 patients) vs. minimally invasive approach (31 patients); one patient was excluded from each group due to postoperative complications. Independent samples T-test was used to compare average values of increase in creatin kinase (CK), which is an enzymatic marker of muscle injury, average surgical time, loss of blood during and after surgery, back pain according to the Visual Analogue Scale (VAS) and day of discharge from the hospital.

Results

Statistically important (P< 0.001) lower blood loss (188 ml vs. 527 ml total), less CK increase (15 ukat/L vs. 29 ukat/L), lower VAS score after surgery (7.3 vs. 8.7) and earlier discharge from the hospital (3.5 days vs. 5.2 days) were observed in the minimally invasive transforaminal lumbar interbody fusion group. No significant difference in average surgical time was recorded.

Conclusions

Our results suggest, that minimally invasive transforaminal lumbar interbody fusion causes is associated with less muscle damage, lower blood loss, less post surgical pain and faster early rehabilitation, which is in accordance with previous studies.

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Author Biographies

Gregor Rečnik, *Univerzitetni klinični center Maribor, Oddelek za ortopedijo, Ljubljanska ulica 5, 2000 Maribor

 

Korespondenca/Correspondence: doc. dr. Gregor Rečnik, dr. med., Oddelek za ortopedijo, UKC Maribor, Ljubljanska ulica 5, 2000 Maribor; telefon: 02 321 14 32; elektronska pošta: gregorrecnik@yahoo.com.


Milko Milčič, *Univerzitetni klinični center Maribor, Oddelek za ortopedijo, Ljubljanska ulica 5, 2000 Maribor
*Univerzitetni klinični center Maribor, Oddelek za ortopedijo, Ljubljanska ulica 5, 2000 Maribor
Samo Karl Fokter, *Univerzitetni klinični center Maribor, Oddelek za ortopedijo, Ljubljanska ulica 5, 2000 Maribor izr. prof.
*Univerzitetni klinični center Maribor, Oddelek za ortopedijo, Ljubljanska ulica 5, 2000 Maribor
Nino Mirnik, *Univerzitetni klinični center Maribor, Oddelek za ortopedijo, Ljubljanska ulica 5, 2000 Maribor
*Univerzitetni klinični center Maribor, Oddelek za ortopedijo, Ljubljanska ulica 5, 2000 Maribor
Andrej Moličnik, *Univerzitetni klinični center Maribor, Oddelek za ortopedijo, Ljubljanska ulica 5, 2000 Maribor asist.
*Univerzitetni klinični center Maribor, Oddelek za ortopedijo, Ljubljanska ulica 5, 2000 Maribor
Matjaž Vogrin, *Univerzitetni klinični center Maribor, Oddelek za ortopedijo, Ljubljanska ulica 5, 2000 Maribor doc. dr.
*Univerzitetni klinični center Maribor, Oddelek za ortopedijo, Ljubljanska ulica 5, 2000 Maribor

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Published
2015-06-29
How to Cite
1.
Rečnik G, Milčič M, Fokter S, Mirnik N, Moličnik A, Vogrin M. Early benefits of minimally invasive transforaminal lumbar interbody fusion in comparison with the traditional open procedure. ZdravVestn [Internet]. 29Jun.2015 [cited 22Nov.2019];84(5). Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/1252
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Original article