title: Microendoscopy-assisted minimally invasive transforaminal lumbar interbody fusion for lumbar degenerative disease: short-term and medium-term outcomes.
abstract: OBJECTIVE
  To evaluate short-term and medium-term outcomes of microendoscopy-assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and open TLIF for lumbar degenerative disease.
  
  
  METHODS
  In this prospective, randomized control study, 50 cases received microendoscopy-assisted MIS-TLIF (MIS group), while another well-matched 50 cases accepted open TLIF (open group). Parameters between both groups, including surgical duration, intraoperative blood loss and radiologic exposure, postoperative analgesic usage and ambulatory time, visual analogue scale (VAS) for back and leg, functional scores, self-evaluation of surgical outcome (modified MacNab criteria), interbody fusion rate, adjacent segment degeneration (ASD) rate, as well as complication incidence were compared at 1 month and 24 months postoperatively.
  
  
  RESULTS
  Intraoperative blood loss and postoperative analgesic usage were significantly reduced in MIS group (P<0.05). Patients undergoing microendoscopy-assisted MIS-TLIF were able to ambulate earlier postoperatively than those receiving open TLIF (P<0.05). However, it showed prolonged surgical duration and enhanced radiologic exposure in MIS group (P<0.05). At 1 month postoperatively, MIS group was associated with more improvement of VAS and functional scores compared with open group (P<0.05). While at 24 months postoperatively, both groups revealed similar VAS and functional scores (P>0.05). Excellent and perfect scale rating by modified MacNab criteria, interbody fusion rate, ASD rate and complication incidence between both groups were nearly the same (P>0.05).
  
  
  CONCLUSIONS
  Microendoscopy-assisted MIS-TLIF owns advantages of less iatrogenic injury, decreased blood loss, reduced analgesic usage and earlier rehabilitation, while it has drawbacks of more surgical duration and radiologic exposure. It is superior than open TLIF in terms of short-term clinical outcomes and has similar medium-term clinical outcomes.
authors.affiliation: Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong Province, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong Province, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong Province, China.
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Rong
authors.affiliation: Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong Province, China.
authors.forename: Rui-Qiang
authors.initials: RQ
authors.lastname: Chen
authors.affiliation: Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong Province, China.
authors.forename: Jian-Wen
authors.initials: JW
authors.lastname: Dong
authors.affiliation: Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong Province, China.
authors.forename: Pei-Gen
authors.initials: PG
authors.lastname: Xie
authors.affiliation: Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong Province, China.
authors.forename: Liang-Ming
authors.initials: LM
authors.lastname: Zhang
authors.affiliation: Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong Province, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Feng
keywords: Minimally invasive; fixed-diameter endoscopy; lumbar degenerative disease; transforaminal lumbar interbody fusion