title: Minimally invasive transforaminal lumbar interbody fusion: Results of 23 consecutive cases.
abstract: BACKGROUND
  The use of minimally invasive surgical (MIS) techniques represents the most recent modification of methods used to achieve lumbar interbody fusion. The advantages of minimally invasive spinal instrumentation techniques are less soft tissue injury, reduced blood loss, less postoperative pain and shorter hospital stay while achieving clinical outcomes comparable with equivalent open procedure. The aim was to study the clinicoradiological outcome of minimally invasive transforaminal lumbar interbody fusion.
  
  
  METHODS
  This prospective study was conducted on 23 patients, 17 females and 6 males, who underwent MIS-transforaminal lumbar interbody fusion (TLIF) followed up for a mean 15 months. The subjects were evaluated for clinical and radiological outcome who were manifested by back pain alone (n = 4) or back pain with leg pain (n = 19) associated with a primary diagnosis of degenerative spondylolisthesis, massive disc herniation, lumbar stenosis, recurrent disc herniation or degenerative disc disease. Paraspinal approach was used in all patients. The clinical outcome was assessed using the revised Oswestry disability index and Macnab criteria.
  
  
  RESULTS
  The mean age of subjects was 55.45 years. L4-L5 level was operated in 14 subjects, L5-S1 in 7 subjects; L3-L4 and double level was fixed in 1 patient each. L4-L5 degenerative listhesis was the most common indication (n = 12). Average operative time was 3 h. Fourteen patients had excellent results, a good result in 5 subjects, 2 subjects had fair results and 2 had poor results. Three patients had persistent back pain, 4 patients had residual numbness or radiculopathy. All patients had a radiological union except for 1 patient.
  
  
  CONCLUSIONS
  The study demonstrates a good clinicoradiological outcome of minimally invasive TLIF. It is also superior in terms of postoperative back pain, blood loss, hospital stay, recovery time as well as medication use.
authors.affiliation: Chirayu Orthopedic and Spine Hospital, Ahmedabad, Gujarat, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Jhala
authors.affiliation: Chirayu Orthopedic and Spine Hospital, Ahmedabad, Gujarat, India.
authors.forename: Damandeep
authors.initials: D
authors.lastname: Singh
authors.affiliation: Chirayu Orthopedic and Spine Hospital, Ahmedabad, Gujarat, India.
authors.forename: Ms
authors.initials: M
authors.lastname: Mistry
keywords: Degenerative spine; Spinal arthritis; lumbar fusion; minimally invasive; minimally invasive transforaminal lumbar interbody fusion; spinal fusion; spondyloarthritis; spondylolisthesis