A study published in Spine compares minimally invasive transforaminal lumbar interbody fusion and lateral interbody fusion for low-grade degenerative spondylolisthesis patients with stenosis.
There were 55 patients examined in the study who underwent surgery for one or two contiguous levels of surgery between L1 and L5. The researchers found:
1. The operative time was similar between both procedures — XLIF was 171 minutes on average compared with TLIF at 186 minutes. Patients in both groups also stayed at the hospital for two days on average.
2. Blood loss was lower among the XLIF patients with 79 percent requiring less than 100 mL of blood, compared with 27 percent of the MIS TLIF group.
3. Patients who underwent XLIF were more likely to experience hip flexion weakness; 31 percent of the XLIF group reported hip flexion weakness with one patient who had a new distal motor weakness and two patients with new sensory changes postoperatively. Zero percent of the MIS TLIF group reported hip flexion weakens; only two patients in the MIS TLIF group had new sensory changes postoperatively.
All hip flexion weakness issues were resolved one year after surgery.
4. Patients in XLIF and MIS TLIF groups reported significant improvement in back and leg pain over two years. A majority — 73 percent — of the XLIF group and 64 percent of the MIS TLIF group reported improvement.
5. The worst leg pain showed improvement similarly between the two groups two years after surgery. The Oswestry Disability Index scores improved in 53 percent of the XLIF group; 57 percent of the MIS TLIF group reported the same.
"These two-year results suggest that both XLIF and MIS TLIF are reasonable MIS approaches for the treatment of lumbar degenerative pathology," concluded the study authors.