Postoperative clinical outcomes in patients undergoing MIS-TLIF versus LLIF for adjacent segment disease

Purpose Few studies examine the clinical outcomes in patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) versus lateral lumbar interbody fusion (LLIF) for adjacent segment disease (ASD). We aim to compare the postoperative clinical trajectory through patient-repo...

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Bibliographic Details
Published in:Acta neurochirurgica 2023-07, Vol.165 (7), p.1907-1914
Main Authors: Nie, James W., Hartman, Timothy J., Zheng, Eileen, MacGregor, Keith R., Oyetayo, Omolabake O., Massel, Dustin H., Sayari, Arash J., Singh, Kern
Format: Article
Language:English
Subjects:
Clinical outcomes
Humans
Interventional Radiology
Leg
Lumbar Vertebrae - surgery
Medicine
Medicine & Public Health
Minimally Invasive Surgery
Minimally Invasive Surgical Procedures - methods
Neurology
Neuroradiology
Neurosurgery
Original Article
Pain - etiology
Patients
Retrospective Studies
Spinal Fusion - methods
Spine - Other
Surgical Orthopedics
Treatment Outcome
Citations: Items that this one cites
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Summary:Purpose Few studies examine the clinical outcomes in patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) versus lateral lumbar interbody fusion (LLIF) for adjacent segment disease (ASD). We aim to compare the postoperative clinical trajectory through patient-reported outcome measures (PROMs) and minimum clinically important difference (MCID) in patients undergoing MIS-TLIF versus LLIF for ASD. Methods Patients were stratified into two cohorts based on surgical technique for ASD: MIS-TLIF versus LLIF. PROMs of 12-Item Short Form Physical Component Score (SF-12 PCS), visual analog scale (VAS) back, VAS leg, and Oswestry Disability Index (ODI) were collected at preoperative and postoperative 6-week/12-week/6-month/1-year time points. MCID attainment was calculated through comparison to established thresholds. Cohorts were compared through nonparametric inferential statistics. Results Fifty-four patients were identified, with 22 patients undergoing MIS-TLIF after propensity score matching. Patients undergoing MIS-TLIF for ASD demonstrated significant postoperative improvement up to 1-year VAS back, up to 1-year VAS leg, and 6-month through 1-year ODI ( p ≤ 0.035, all). Patients undergoing LLIF demonstrated significant postoperative improvement in 6-month SF-12 PCS, 6-month through 1-year VAS back, 12-week through 6-month VAS leg, and 6-month to 1-year ODI ( p ≤ 0.035, all). No significant differences were calculated between surgical techniques for PROMs or MCID achievement rates. Conclusion Patients undergoing either MIS-TLIF or LLIF for adjacent segment disease demonstrated significant postoperative improvement in pain and disability outcomes. Additionally, patients undergoing LLIF reported significant improvement in physical function. Both MIS-TLIF and LLIF are effective for the treatment of adjacent segment disease.
ISSN:0942-0940
0001-6268
0942-0940
DOI:10.1007/s00701-023-05629-z