Minimally Invasive Transforaminal Lumbar Interbody Fusion A Review of Techniques and Outcomes

Study Design. Review of published literature. Objective. To review the available medical literature reporting results after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) and evaluate functional and radiographic outcomes with those following open TLIF and open posterior lumbar interbody fusion (PLIF) procedures. Summary of Background Data. Minimally invasive spine techniques aim to reduce approach-related surgical morbidity without compromising operative and clinical outcomes. MIS TLIF is increasingly being used for the management of various lumbar degenerative diseases. Despite the limited number of well-designed clinical studies, the available published data suggest potential advantages over its open posterior-approach lumbar interbody fusion counterparts. Such benefits include less intraoperative blood loss, less need for blood transfusions, shorter hospital course, and less postoperative pain. Methods. Literature examining posterior-approach interbody fusion techniques (PLIF, TLIF, and MIS TLIF) was collected using the National Center for Biotechnology Information database and PubMed/MEDLINE, and summarized for discussion. Results. Literature reports of MIS TLIF generally show comparable or improved clinical outcomes when compared with those following open posterior interbody fusion techniques. Additionally, significantly less blood loss, hospital stay, and complications were generally reported, despite slightly longer duration of surgery, especially during early cases in a surgeon's experience. Conclusion. More studies designed to provide class I or II data will be needed in the future to further solidify the favorable results observed so far with the MIS TLIF procedure.