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Minimally Invasive Fusion Found Superior to Open Surgery

Better clinical outcomes seen in transforaminal lumbar interbody fusion in 1-level fusion

FRIDAY, Aug. 13 (HealthDay News) -- Minimally invasive transforaminal lumbar interbody fusion (TLIF) is superior to open surgical approaches for the treatment of 1-level degenerative lumbar diseases, according to research published in the Aug. 1 issue of Spine.

Fan Shunwu, M.D., of the Medical College of Zhejiang University in Hangzhou, China, and colleagues conducted a prospective cohort study to determine if a minimally invasive TLIF procedure using the tubular retractor system resulted in less approach-related morbidity than conventional open surgery for 1-level degenerative lumbar disease. Sixty-two patients in one institution underwent a TLIF procedure performed by the same surgeon, with 32 undergoing the minimally invasive procedure using the tubular retractor system, and 30 undergoing the traditional open approach.

Although the open-procedure group of patients had a shorter operative time, the researchers found that the patients in the minimally-invasive group had less blood loss, fewer transfusions, less postoperative pain, a shorter hospital stay, lower creatine kinase levels, and lower disability and visual analog scores. Complications were similar between groups, although the minimally-invasive group had two cases of screw malposition.

"The minimally invasive procedure was superior in terms of postoperative back pain, total blood loss, transfusion, time to ambulation, length of hospital stay, soft-tissue injury, and functional recovery. However, it required a somewhat longer operation and closer attention to the risk of technical complications," the authors write.

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