Awake MIS transforaminal lumbar interbody fusion may yield safe, effective outcomes

Published results showed awake endoscopic minimally invasive transforaminal lumbar interbody fusion may be a safe and efficacious option for lumbar fusion with less morbidity compared with open surgery.

John Paul G. Kolcun, BS, and colleagues collected Oswestry Disability Index (ODI) score preoperatively and at 3-month intervals postoperatively among 100 patients who underwent awake endoscopic MIS-transforaminal lumbar interbody fusion between 2014 and 2017. Researchers compared preoperative the ODI score with the most recent ODI scores available 1 year postoperatively or later.

Among the patients included, results showed 84 patients underwent single-level fusion and 16 patients underwent two-level fusion, with level L4-5 representing 77% of all fused levels. Researchers found a mean length of hospital stay of approximately 1.4 days.

Overall, four deaths occurred from complications unrelated to surgery, according to researchers. At 1-year follow-up, results showed a significant mean reduction in the ODI score from approximately 29.6 preoperatively to 17.2 postoperatively in 82% of surviving patients. Researchers noted other complications included cage migration, osteomyelitis and endplate fracture.

“This study demonstrates that the awake [transforaminal lumbar interbody fusion] TLIF — an endoscopic method for transforaminal lumbar interbody fusion without general endotracheal anesthesia — achieves significant, durable pain relief and functional improvement in appropriate patients,” Kolcun told Healio.com/Orthopedics. “These clinical results were accomplished with a low operative time, blood loss and hospital length of stay as compared to conventional minimally invasive techniques.” – by Casey Tingle

Disclosure s : Kolcun reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.

Published results showed awake endoscopic minimally invasive transforaminal lumbar interbody fusion may be a safe and efficacious option for lumbar fusion with less morbidity compared with open surgery.

John Paul G. Kolcun, BS, and colleagues collected Oswestry Disability Index (ODI) score preoperatively and at 3-month intervals postoperatively among 100 patients who underwent awake endoscopic MIS-transforaminal lumbar interbody fusion between 2014 and 2017. Researchers compared preoperative the ODI score with the most recent ODI scores available 1 year postoperatively or later.

Among the patients included, results showed 84 patients underwent single-level fusion and 16 patients underwent two-level fusion, with level L4-5 representing 77% of all fused levels. Researchers found a mean length of hospital stay of approximately 1.4 days.

Overall, four deaths occurred from complications unrelated to surgery, according to researchers. At 1-year follow-up, results showed a significant mean reduction in the ODI score from approximately 29.6 preoperatively to 17.2 postoperatively in 82% of surviving patients. Researchers noted other complications included cage migration, osteomyelitis and endplate fracture.

“This study demonstrates that the awake [transforaminal lumbar interbody fusion] TLIF — an endoscopic method for transforaminal lumbar interbody fusion without general endotracheal anesthesia — achieves significant, durable pain relief and functional improvement in appropriate patients,” Kolcun told Healio.com/Orthopedics. “These clinical results were accomplished with a low operative time, blood loss and hospital length of stay as compared to conventional minimally invasive techniques.” – by Casey Tingle

Disclosure s : Kolcun reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.