gms | German Medical Science

The objective of this lecture is to demonstrate the feasability, safety and reproducibility of the mini-invasive TLIFcompared to open approach TLIF.

The authors review a small serie of 8 Mini-invasive TLIF and discuss the benefits of the mini-invasive approach compared to the open TLIF. They compare the post-op period in term of pain, hospital stay and the return to normal activities. The authors point out the advantages and limitations of the mini-invasive approach compared to the open one.

Comparing the neurological outcome there is no difference in the long-term results between open or mini-invasive TLIF. However the Mini-invasive approach has the benefit of preserving the muscle function and insertion resulting in less post-op pain, a better muscular scar and a quicker rehabilitation. The objective of the surgery was achieved in all cases except in one case in which interbody distraction failed because of the osteoporotic bone and the subsidence of the endplate. In this particular case the open approach might be more effective as far as distarction could be achieved by simultaneous interbody and interpedicular manoeuvers.

The transforaminal inetrbody fusion technique is an effective technique for a 360° lumbar fusion. The open approach is well described in the litterature and has proven the efficacy and safety of this procedure. Transmuscular mini-invasive aproach could be a good alternative in specific indication and has the advantages of preserving the muscle attachment and minimize the trauma-related approach. The authors advise the use of this technique while the open approach still the "gold standard".