title: Clinical outcomes of minimally invasive versus open approach for one-level transforaminal lumbar interbody fusion at the 3- to 4-year follow-up.
abstract: OBJECTIVE
  Supporters of minimally invasive approaches for transforaminal lumbar interbody fusion (TLIF) have reported short-term advantages associated with a reduced soft tissue trauma. Nevertheless, mid- and long-term outcomes and specifically those involving physical activities have not been adequately studied. The aim of this study was to compare the clinical outcomes of mini-open versus classic open surgery for one-level TLIF, with an individualized evaluation of the variables used for the clinical assessment.
  
  
  METHODS
  A prospective cohort study was conducted of 41 individuals with degenerative disc disease who underwent a one-level TLIF from January 2007 to June 2008. Patients were randomized into two groups depending on the type of surgery performed: classic open (CL-TLIF) group and mini-open approach (MO-TLIF) group. The visual analog scale (VAS), North American Spine Society (NASS) Low Back Pain Outcome instrument, Oswestry Disability Index (ODI) and the Short Form 36 Health Survey (SF-36) were used for clinical assessment in a minimum 3-year follow-up (36-54 months).
  
  
  RESULTS
  Patients of the MO-TLIF group presented lower rates of lumbar (p = 0.194) and sciatic pain (p = 0.427) and performed better in daily life activities, especially in those requiring mild efforts: lifting slight weights (p = 0.081), standing (p = 0.097), carrying groceries (p = 0.033), walking (p = 0.069) and dressing (p = 0.074). Nevertheless, the global scores of the clinical questionnaires showed no statistical differences between the CL-TLIF and the MO-TLIF groups.
  
  
  CONCLUSIONS
  Despite an improved functional status of MO-TLIF patients in the short term, the clinical outcomes of mini-open TLIF at the 3- to 4-year follow-up showed no clinically relevant differences to those obtained with open TLIF.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, "Miguel Servet" University Hospital, Isabel La Católica s/n, 5009, Zaragoza, Spain, jrodriguezvela@hotmail.com.
authors.forename: Javier
authors.initials: J
authors.lastname: Rodríguez-Vela
authors.forename: Antonio
authors.initials: A
authors.lastname: Lobo-Escolar
authors.forename: Eduardo
authors.initials: E
authors.lastname: Joven
authors.forename: Javier
authors.initials: J
authors.lastname: Muñoz-Marín
authors.forename: Antonio
authors.initials: A
authors.lastname: Herrera
authors.forename: José
authors.initials: J
authors.lastname: Velilla
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006987:Hypesthesia / Q000175:diagnosis / Q000209:etiology; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D007902:Length of Stay; D017116:Low Back Pain / Q000175:diagnosis / Q000209:etiology; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D012585:Sciatica / Q000175:diagnosis / Q000209:etiology; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome