OUTCOME OF MINIMALLY INVASIVE SURGERY TRANSFORAMINAL LUMBAR INTERBODY FUSION (MISTLIF) IN UKMMC
Mohamed Mishwaar Ashfaq, Mohd Hisam Muhamad Ariffin, Shaharuddin Abdul Rani, Azmi bin Baharuddin, Kamalnizat bin Ibrahim
Introduction:
MIS TLIF is a technique which preserves much of the Paraspinal muscles and is known to produce excellent results postoperatively compared to the open TLIF method.
Materials and Methods:
The purpose of this retrospective study is to evaluate the clinical outcome of MIS TLIF over a period of 24 months follow up. Sixty-two (62) patients underwentMIS TLIF. Forty one (41) patients were able to complete the 24 months. Clinical outcomes were assessed using VAS, ODI, and SF-36 and serial radiographs were obtained at 6 weeks, 3 months,6 months, 12 months and 24 months at UKM spine clinic.
Results:
There were 16 males, 25 females with 2 year follow up, and mean age 58.41 yrs. 26 patients underwent single level fusion and 15 patients’ more than one level fusion. 44% had spondylolisthesis 56% had degenerative disc disease. Mean operative time was 123.24 mins. Mean blood loss was 200 ml Mean hospital stay was 5.7 days. Improvement of ODI from 51.9 % to 9.78%. VAS improved as well from 7.79 to 1.41. No patient had to be converted to Open TLIF. There were three cases of dural tear, one screw cut out and one infection.
Discussions:
MIS TLIF is an effective technique in our retrospective clinical study of 41 patientswhom there was an excellent clinical outcomes. All patients showed remarkable improvement on their ODI, VAS and SF 36 domains during the follow ups even though many argue regardingsimilar outcomes of open vs MIS TLIF. However it is the first 24 months that makes the MIS TLIF a far superior option compared to the Open TLIF.
Conclusion:
MIS TLIF is a safe and effective technique with an outstanding result that meets the expectation of the patients in the early postoperative period.