Comparison of the Outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion and Endoscopic Transforaminal Lumbar Interbody Fusion for Lumbar Diseases: A Matched Case-Control

OBJECTIVE: We compared the clinical outcomes of minimally invasive transforaminal lumbar interbody fusion (Mis-TLIF) and endoscopic transforaminal lumbar interbody fusion (Endo-TLIF). -METHODS: We retrospectively analyzed the clinical data of patients who underwent single-segment Mis-TLIF or Endo-TLIF between June 2016 and June 2019 at our hospital. The patients in each treatment group were matched 1:1 for sex, age, and type of lumbar degenerative disease, and their clinical outcomes were compared at discharge and at 1 and 2 years postoperatively. -RESULTS: Our study included 64 patients, with 32 pa-tients in each treatment group. Operative time and fluo-roscopy time were significantly higher in the Endo-TLIF versus Mis-TLIF groups, whereas estimated blood loss, postoperative drainage volume, and the low back pain vi-sual analog scale score at discharge were significantly lower. Both treatments achieved exact interbody fusion at the final-follow up. There was no significant difference in the visual analog scale score or Oswestry Disability Index between the groups at 1 and 2 years postoperatively. Complication rates were higher in the Endo-TLIF group (21.9%) than in the Mis-TLIF group (6.2%), although the difference was not significant.CONCLUSIONS: Although there was no difference in the long-term outcomes between the treatments, Endo-TLIF had less blood loss and a lower postoperative drainage volume and low back pain visual analog scale score at discharge than Mis-TLIF. However, the longer operative time and potentially higher complication rate of Endo-TLIF suggest that surgeons may need to overcome the steeper learning curve than the procedure of Mis-TLIF.

Automated summary

This study compared the clinical outcomes of Mis-TLIF and Endo-TLIF, finding that Endo-TLIF had less blood loss and lower postoperative drainage volume, but Mis-TLIF had shorter operative time and lower complication rates. There was no significant difference in long-term outcomes between the two treatments.