title: Complications and perioperative factors associated with learning the technique of minimally invasive transforaminal lumbar interbody fusion (TLIF).
abstract: Before the advent of minimally invasive spine surgery (MIS), open transforaminal lumbar interbody fusion (TLIF) was performed to treat spondylosis, spondylolisthesis, and spondylolysis. Minimally invasive TLIF has recently become more popular based upon the premise that a smaller, less traumatic incision should afford better recovery and outcomes. However, the learning curve associated with this technique must be considered. To analyze the perioperative factors associated with the learning curve in patients who underwent MIS TLIF versus open TLIF, we identified 22 patients who underwent TLIF from 2005 to 2008 within levels L4-S1 by the senior author (D.C.). Patients were subdivided into two groups according to whether they underwent: (i) MIS TLIF (10 patients, the first MIS TLIF procedures performed by D.C.); or (ii) open TLIF (12 patients). Preoperative, perioperative and postoperative factors were evaluated. Patients who underwent MIS TLIF had a statistically significant lower intraoperative transfusion rate, and rate of required postoperative surgical drains; and shorter periods of required drainage, and time to ambulation. However, the MIS TLIF group tended to have a higher rate of complications, which might have been associated with the learning curve. Both groups had a minimum of 1-year follow-up.
authors.affiliation: Department of Neurosurgery, University of California San Francisco, 505 Parnassus Avenue, Box 0112, San Francisco, CA 94143-0112, USA.
authors.forename: Darryl
authors.initials: D
authors.lastname: Lau
authors.forename: Jasmine G
authors.initials: JG
authors.lastname: Lee
authors.forename: Seunggu J
authors.initials: SJ
authors.lastname: Han
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Lu
authors.forename: Dean
authors.initials: D
authors.lastname: Chou
mesh_terms: D005260:Female; D006801:Humans; D059032:Learning Curve; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000193:education* / Q000379:methods; D059035:Perioperative Period; D013123:Spinal Fusion / Q000009:adverse effects / Q000193:education* / Q000379:methods; D055009:Spondylosis / Q000601:surgery*; D016896:Treatment Outcome