title: Minimally invasive posterior transforaminal lumbar interbody fusion: One-year postoperative morbidity, clinical and radiological results of a prospective multicenter study of 182 cases.
abstract: BACKGROUND
  Interbody fusion is the gold standard treatment for the management of numerous diseases of the spine. Minimally invasive techniques may be more beneficial than conventional techniques. The main goal of this study was to report the one-year postoperative results of a series of posterior lumbar interbody fusions by a minimally invasive technique in relation to improvement in functional outcome, interbody fusion and morbidity.
  
  
  METHODS
  Between January 2012 and May 2013, 182 patients treated by minimally invasive posterior transforaminal lumbar interbody fusion (TLIF) were included in this prospective multicenter study. Clinical assessment was based on a comparison of the preoperative and one-year postoperative Oswestry (ODI), SF-12 and Quebec Scores and the Visual Analog Scale (VAS). Surgical and postoperative follow-up data were evaluated. Radiological assessment was based preoperative and one-year postoperative full spine teleradiographs. Interbody fusion at one-year was systematically evaluated by CT scan.
  
  
  RESULTS
  One hundred and eighty-two patients were included, mean age 58.9 years old. Surgery lasted a mean 101 minutes, mean preoperative bleeding was 143 mL, and mean radiation exposure was 247.4 cGy/cm(2). The rate of postoperative complications was 7.7%. The ODI, the Quebec Score, the SF-12 and the VAS were all significantly improved at one-year (P<0.0001). The rate of fusion was 72.6% at the final follow-up. There was no significant difference in functional outcome between patients with and without fusion.
  
  
  CONCLUSIONS
  The one-year postoperative radiological results and functional outcome of minimally invasive posterior lumbar fusion are satisfactory. The benefits of this minimally invasive approach are mainly found in the first 6 postoperative months. Successful radiological interbody fusion was not correlated to functional outcome at the final follow-up.
authors.affiliation: Service de chirurgie orthopédique, université Aix-Marseille, CHU La Timone, 13005 Marseille, France.
authors.forename: H
authors.initials: H
authors.lastname: Giorgi
authors.affiliation: Centre du rachis, clinique Saint-Léonard, Angers, France.
authors.forename: R
authors.initials: R
authors.lastname: Prébet
authors.affiliation: Centre du rachis, clinique Saint-Léonard, Angers, France.
authors.forename: M
authors.initials: M
authors.lastname: Delhaye
authors.affiliation: Centre Aquitain-du-Dos, Mérignac, France.
authors.forename: N
authors.initials: N
authors.lastname: Aurouer
authors.affiliation: Centre Aquitain-du-Dos, Mérignac, France.
authors.forename: P
authors.initials: P
authors.lastname: Mangione
authors.affiliation: Service de chirurgie orthopédique, université Aix-Marseille, CHU La Timone, 13005 Marseille, France.
authors.forename: B
authors.initials: B
authors.lastname: Blondel
authors.affiliation: Service de chirurgie orthopédique, université Aix-Marseille, CHU La Timone, 13005 Marseille, France.
authors.forename: P
authors.initials: P
authors.lastname: Tropiano
authors.affiliation: Service de neurochirurgie, université Aix-Marseille, CHU La Timone, Marseille, France.
authors.forename: S
authors.initials: S
authors.lastname: Fuentes
authors.affiliation: Centre du rachis, clinique Saint-Léonard, Angers, France.
authors.forename: H-F
authors.initials: HF
authors.lastname: Parent
mesh_terms: D000328:Adult; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009017:Morbidity / Q000639:trends; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D013123:Spinal Fusion / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: Minimally invasive surgery; Morbidity; Posterior lumbar fusion; Prospective study; Transforaminal interbody fusion