title: Surgical data and early postoperative outcomes after minimally invasive lumbar interbody fusion: results of a prospective, multicenter, observational data-monitored study.
abstract: Minimally invasive lumbar interbody fusion (MILIF) offers potential for reduced operative morbidity and earlier recovery compared with open procedures for patients with degenerative lumbar disorders (DLD). Firm conclusions about advantages of MILIF over open procedures cannot be made because of limited number of large studies of MILIF in a real-world setting. Clinical effectiveness of MILIF in a large, unselected real-world patient population was assessed in this Prospective, monitored, international, multicenter, observational study.
  
  
  OBJECTIVE
  To observe and document short-term recovery after minimally invasive interbody fusion for DLD.
  
  
  METHODS
  In a predefined 4-week analysis from this study, experienced surgeons (≥ 30 MILIF surgeries pre-study) treated patients with DLD by one- or two-level MILIF. The primary study objective was to document patients' short-term post-interventional recovery (primary objective) including back/leg pain (visual analog scale [VAS]), disability (Oswestry Disability Index [ODI]), health status (EQ-5D) and Patient satisfaction.
  
  
  RESULTS
  At 4 weeks, 249 of 252 patients were remaining in the study; the majority received one-level MILIF (83%) and TLIF was the preferred approach (94.8%). For one-level (and two-level) procedures, surgery duration was 128 (182) min, fluoroscopy time 115 (154) sec, and blood-loss 164 (233) mL. Time to first ambulation was 1.3 days and time to study-defined surgery recovery was 3.2 days. Patients reported significantly (P < 0.0001) reduced back pain (VAS: 2.9 vs 6.2), leg pain (VAS: 2.5 vs 5.9), and disability (ODI: 34.5% vs 45.5%), and a significantly (P < 0.0001) improved health status (EQ-5D index: 0.61 vs 0.34; EQ VAS: 65.4 vs 52.9) 4 weeks postoperatively. One adverse event was classified as related to the minimally invasive surgical approach. No deep site infections or deaths were reported.
  
  
  CONCLUSIONS
  For experienced surgeons, MILIF for DLD demonstrated early benefits (short time to first ambulation, early recovery, high patient satisfaction and improved patient-reported outcomes) and low major perioperative morbidity at 4 weeks postoperatively.
authors: Neurosurgery, Centro Hospitalar S. Joao, Porto, Portugal.
authors: Paulo
authors: P
authors: Pereira
authors: Karvinska hornicka nemocnice, Karvina, Czech Republic.
authors: David
authors: D
authors: Buzek
authors: Klinikum Dortmund, Dortmund, Germany.
authors: Jörg
authors: J
authors: Franke
authors: Klinikum Amstetten, Amstetten, Austria.
authors: Wolfgang
authors: W
authors: Senker
authors: Klinikum Kulmbach, Kulmbach Bayern, Germany.
authors: Arkadiusz
authors: A
authors: Kosmala
authors: Universitatsklinikum Freiburg, Freiburg, Germany.
authors: Ulrich
authors: U
authors: Hubbe
authors: Orthopaedic Surgery, Horizon Health Network, Saint John, NB, Canada.
authors: Neil
authors: N
authors: Manson
authors: Franciscus Ziekenhuis, Rosendaal, The Netherlands.
authors: Wout
authors: W
authors: Rosenberg
authors: Fatebenefratelli Hospital, Milano, Italy.
authors: Roberto
authors: R
authors: Assietti
authors: Onze Lieve Vrouw Ziekenhuis, Aalst, Belgium.
authors: Frederic
authors: F
authors: Martens
authors: Istituti Ortopedici Rizzoli, Bologna, Italy.
authors: Giovanni
authors: G
authors: Barbanti Brodano
authors: Hospital zum Heiligen Geist Kempen, Kempen, Germany.
authors: Kai-Michael
authors: KM
authors: Scheufler
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D011446:Prospective Studies; D057566:Self Report; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome