Long-term Functional and Radiological Outcome of Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS TLIF) in Lumbar Degenerative Diseases: A Retrospective Study in 110 Patients

Author(s): Anson Albert Macwan, Nevish H Patel, Yashvi Modi, Hitesh N Modi

Materials and Methods: This retrospective study evaluated 110 patients who underwent minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) from 2014 to 2022. Inclusion criteria involved patients with chronic back and leg pain for over six weeks unresponsive to conservative treatments, including one or two-level lumbar canal stenosis or spondylolisthesis. Exclusion criteria comprised previous spinal surgeries, traumatic injuries, tumors, and poor-quality imaging. Preoperative evaluations included neurological assessments and imaging, such as static and dynamic radiographs and MRIs. Outcomes were measured based on estimated blood loss, length of hospital stay, operative time, complications, Visual Analog Scale (VAS) scores, and Oswestry Disability Index (ODI) scores. Statistical analysis utilized SPSS, with significance set at p < 0.05.

Results: The cohort (mean age 53.34 ± 10.6 years) included 68 patients undergoing single-level and 42 double-level MIS TLIF. The average operative time was 137 ± 22.5 minutes, estimated blood loss averaged 137 ± 39 mL, and hospital stay was 4 ± 0.8 days. Complications were reported in 12 patients (10.9%), including cage back-out (3), adjacent level disease (2), and other minor complications. Clinical outcomes revealed significant improvement, with VAS scores decreasing from 7.7 ± 0.8 preoperatively to 2.7 ± 0.7 postoperatively (p < 0.0008). ODI scores improved from 48 ± 6.14 to 22 ± 3.7 (p < 0.0007). Postoperative lumbar lordosis and pelvic incidence remained stable.

Conclusion: MIS TLIF demonstrates efficacy as a surgical intervention for lumbar degenerative diseases, delivering positive long-term functional and radiological outcomes. The technique is associated with lower perioperative morbidity, shorter hospital stays, and substantial pain relief with significant improvement in VAS and ODI scores. These results endorse MIS TLIF as a preferred alternative to traditional open surgery in suitable patient populations.