Comparison of Short-term Efficacy of MIS-TLIF and Endo-LIF in the Treatment of Single-segment Degenerative Lumbar Diseases

Overview

Journal Front Surg

Specialty General Surgery

Date 2022 Oct 10

PMID 36211296

Authors

Zhiwei Song

Weihua Zhu

Junwen Zheng

Gang Wu

Tianqi Li

Aibing Huang

Jian Bian

Chunmao Chen

Haijun Li

Affiliations

Soon will be listed here.

Abstract

Background: A prospective controlled study was conducted to compare the short-term clinical results and postoperative complications of minimally invasive transforaminal lumbar decompression and fusion (minimally invasive surgery transforaminal lumbar interbody fusion, MIS-TLIF) and percutaneous endoscope-assisted transforaminal lumbar interbody fusion (endoscopic lumbar interbody fusion, Endo-LIF) in the treatment of single-segment degenerative lumbar diseases, to provide some scientific guidance for clinicians to select surgical treatment for patients with lumbar degeneration.

Methods: From October 2020 to October 2021, a total of 62 patients were enrolled, with 31 patients in the MIS-TLIF group and 31 patients in the Endo-LIF group. All patients were followed up for 6 months. The following information from the two groups of patients was recorded: (1) operation time, radiation exposure time, intraoperative blood loss, bed rest time, and hospital stay; (2) ODI score (The Oswestry Disability Index), low back pain VAS score (Visual Analogue Scale), and lumbar vertebra JOA score (Japanese Orthopaedic Association Scores) 1 day before the operation; 1, 3, 6 days after operation; and 1, 3 and 6 months after operation. (3) X-ray evaluations of lumbar fusion at the last follow-up.

Results: There were significant differences in operation time, intraoperative fluoroscopy time, and hospitalization cost between the two groups. The MIS-TLIF group was significantly better than the Endo-LIF group, and the intraoperative bleeding volume of the Endo-LIF group was significantly better than that of the MIS-TLIF group, but there was no significant difference in postoperative bed rest time and postoperative hospital stay. There was no significant difference in the scores of ODI, VAS, and JOA between the two groups before and after the operation. At the last follow-up, the fusion rate was 100% in the MIS-TLIF group and 100% in the Endo-LIF group.

Conclusions: There was no significant difference in short-term clinical efficacy and safety between Endo-LIF and MIS-TLIF in the treatment of single-segment degenerative lumbar diseases, but MIS-TLIF was significantly better than Endo-LIF in terms of the operation time, hospitalization cost, and fluoroscopy time, and Endo-LIF was significantly better than MIS-TLIF in terms of intraoperative blood loss.

Citing Articles

Innovative Nerve Root Protection in Full-Endoscopic Facet-Resecting Lumbar Interbody Fusion: Controlled Cage Glider Rotation Using the GUARD (Glider Used As a Rotary Device) Technique.

Hsu Y, Chuang H, Chang W, Liu Y, Chang C, Hsiao Y Neurospine. 2025; 21(4):1141-1148.

PMID: 39765257 PMC: 11744537. DOI: 10.14245/ns.2449126.563.

A retrospective comparative study of robot-assisted unilateral biportal endoscopic lumbar decompression and fusion surgery versus percutaneous endoscopic lumbar decompression and fusion surgery.

Liu Y, Deng Q, Han L, Zhang K, Zhang Y, Peng R Medicine (Baltimore). 2024; 103(39):e39664.

PMID: 39331906 PMC: 11441851. DOI: 10.1097/MD.0000000000039664.

Comparison of the short-term efficacy of MIS-TLIF and Endo-LIF for the treatment of two-segment lumbar degenerative disease.

Zhuo C, Liu Y, Zhang Y, Zhang R, Wang L, Yang D BMC Musculoskelet Disord. 2024; 25(1):708.

PMID: 39232720 PMC: 11373331. DOI: 10.1186/s12891-024-07815-1.

Is endoscopic technique an effective and safe alternative for lumbar interbody fusion? A systematic review and meta-analysis.

Relvas-Silva M, Sousa Pinto B, Sousa A, Loureiro M, Pinho A, Pereira P EFORT Open Rev. 2024; 9(6):536-555.

PMID: 38828975 PMC: 11195334. DOI: 10.1530/EOR-23-0167.

Evaluation of the learning curve and complications in unilateral biportal endoscopic transforaminal lumbar interbody fusion: cumulative sum analysis and risk-adjusted cumulative sum analysis.

Guo W, Ye J, Li T, Yu Y, Fan X J Orthop Surg Res. 2024; 19(1):194.

PMID: 38509573 PMC: 10956305. DOI: 10.1186/s13018-024-04674-3.

References

Khan N, Clark A, Lee S, Venable G, Rossi N, Foley K . Surgical Outcomes for Minimally Invasive vs Open Transforaminal Lumbar Interbody Fusion: An Updated Systematic Review and Meta-analysis. Neurosurgery. 2015; 77(6):847-74. DOI: 10.1227/NEU.0000000000000913. View

Azimi P, Mohammadi H, Montazeri A . An outcome measure of functionality and pain in patients with lumbar disc herniation: a validation study of the Japanese Orthopedic Association (JOA) score. J Orthop Sci. 2012; 17(4):341-5. DOI: 10.1007/s00776-012-0232-x. View

Li R, Li X, Zhou H, Jiang W . Development and Application of Oblique Lumbar Interbody Fusion. Orthop Surg. 2020; 12(2):355-365. PMC: 7967883. DOI: 10.1111/os.12625. View

Wu W, Yang S, Diao W, Wang D, Guo Y, Yan M . Analysis of clinical efficacy of endo-LIF in the treatment of single-segment lumbar degenerative diseases. J Clin Neurosci. 2019; 71:51-57. DOI: 10.1016/j.jocn.2019.11.004. View

Liang Y, Shi W, Jiang C, Chen Z, Liu F, Feng Z . Clinical outcomes and sagittal alignment of single-level unilateral instrumented transforaminal lumbar interbody fusion with a 4 to 5-year follow-up. Eur Spine J. 2015; 24(11):2560-6. DOI: 10.1007/s00586-015-3933-y. View

Ruiz F, Bohl D, Webb M, Russo G, Grauer J . Oswestry Disability Index is a better indicator of lumbar motion than the Visual Analogue Scale. Spine J. 2013; 14(9):1860-5. DOI: 10.1016/j.spinee.2013.10.027. View

Li X, Hu Z, Cui J, Han Y, Pan J, Yang M . Percutaneous endoscopic lumbar discectomy for recurrent lumbar disc herniation. Int J Surg. 2016; 27:8-16. DOI: 10.1016/j.ijsu.2016.01.034. View

Allain J, Dufour T . Anterior lumbar fusion techniques: ALIF, OLIF, DLIF, LLIF, IXLIF. Orthop Traumatol Surg Res. 2019; 106(1S):S149-S157. DOI: 10.1016/j.otsr.2019.05.024. View

Li H, Ge D, Zhang S, Aisikeerbayi A, Wang H, He Y . Comparative study between mini-open TLIF via Wiltse's approach and conventional open TLIF in lumbar degenerative diseases. Eur Rev Med Pharmacol Sci. 2018; 22(1 Suppl):53-62. DOI: 10.26355/eurrev_201807_15364. View

10.

Lau D, Terman S, Patel R, La Marca F, Park P . Incidence of and risk factors for superior facet violation in minimally invasive versus open pedicle screw placement during transforaminal lumbar interbody fusion: a comparative analysis. J Neurosurg Spine. 2013; 18(4):356-61. DOI: 10.3171/2013.1.SPINE12882. View

11.

Prince M, Wu F, Guo Y, Gutierrez Robledo L, ODonnell M, Sullivan R . The burden of disease in older people and implications for health policy and practice. Lancet. 2014; 385(9967):549-62. DOI: 10.1016/S0140-6736(14)61347-7. View

12.

Cannestra A, Peterson M, Parker S, Roush T, Bundy J, Turner A . MIS Expandable Interbody Spacers: A Literature Review and Biomechanical Comparison of an Expandable MIS TLIF With Conventional TLIF and ALIF. Spine (Phila Pa 1976). 2016; 41 Suppl 8:S44-9. DOI: 10.1097/BRS.0000000000001465. View

13.

Czabanka M, Thome C, Ringel F, Meyer B, Eicker S, Rohde V . [Operative treatment of degenerative diseases of the lumbar spine]. Nervenarzt. 2018; 89(6):639-647. DOI: 10.1007/s00115-018-0523-3. View

14.

Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F . A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012; 64(6):2028-37. DOI: 10.1002/art.34347. View

15.

Bydon M, Alvi M, Goyal A . Degenerative Lumbar Spondylolisthesis: Definition, Natural History, Conservative Management, and Surgical Treatment. Neurosurg Clin N Am. 2019; 30(3):299-304. DOI: 10.1016/j.nec.2019.02.003. View

16.

Heller G, Manuguerra M, Chow R . How to analyze the Visual Analogue Scale: Myths, truths and clinical relevance. Scand J Pain. 2017; 13:67-75. DOI: 10.1016/j.sjpain.2016.06.012. View

17.

Garcia-Ramos C, Valenzuela-Gonzalez J, Baeza-Alvarez V, Rosales-Olivarez L, Alpizar-Aguirre A, Reyes-Sanchez A . Degenerative spondylolisthesis I: general principles. Acta Ortop Mex. 2021; 34(5):324-328. View

18.

Sembrano J, Tohmeh A, Isaacs R . Two-year Comparative Outcomes of MIS Lateral and MIS Transforaminal Interbody Fusion in the Treatment of Degenerative Spondylolisthesis: Part I: Clinical Findings. Spine (Phila Pa 1976). 2016; 41 Suppl 8:S123-32. DOI: 10.1097/BRS.0000000000001471. View

19.

Hussain I, Kirnaz S, Wibawa G, Wipplinger C, Hartl R . Minimally Invasive Approaches for Surgical Treatment of Lumbar Spondylolisthesis. Neurosurg Clin N Am. 2019; 30(3):305-312. DOI: 10.1016/j.nec.2019.02.004. View

20.

Xu D, Walker C, Godzik J, Turner J, Smith W, Uribe J . Minimally invasive anterior, lateral, and oblique lumbar interbody fusion: a literature review. Ann Transl Med. 2018; 6(6):104. PMC: 5900070. DOI: 10.21037/atm.2018.03.24. View