Comparison between Minimally Invasive Transforaminal Lumbar Interbody Fusion and Open Sur-gery in treatment of Discogenic Low Back Pain

Abstract：Objective To compare the clinical outcomes between minimally invasive transforaminal lumbar interbody fu-sion and conventional open transforaminal lumbar interbody fusion in treatment of discogenic low back pain. Methods From June 2008 to June 2010,58 patients with single-level discogenic low back pain who underwent transforaminal lumbar interbody fusion were enrolled in our study,including 28 cases with mini-TLIF and 30 cases with open-TLIF. Perioperative indexes,para-vertebral muscle injury,clinical outcomes were assessed. Results Length of incision,intraoperative blood loss,postoperative drainage,postoperative hospital stay,average time of returning to work,serum creatine kinase at 3 days postoperatively in the group of mini-TLIF were significantly better than the group of open-TLIF(P < 0. 05). However,mini-TLIF needs more opera-tion time and radiation exposure. At 1-year follow-up,surface electromyography of paravertebral muscle showed that average discharge amplitude and frequency were significantly lower in the group of open-TLIF than the group of mini-TLIF(P < 0. 05). At 3 months,6 months and 1-year follow-up,the VAS and ODI score in patients with mini-TLIF showed significantly more im-provement than open-TLIF. However,there were no significant differences at 2-year and last follow-up(P > 0. 05). Conclusion Minimally invasive TLIF has similar short-term surgical outcmes with traditional open surgery in treating single-level disco-genic low back pain. But the minimally invasive surgery could offer several potential advantages including less surgical trauma, quicker recovery,less paraspinal muscle injury and better early result.