Review Article

Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Perspective on Current Evidence and Clinical Knowledge

Table 1

Summary of research studies reporting data on MI-TLIF.

Author (year)Study designFollow-upNumber of patientsSignificant results

Scheufler et al. (2007) [10]Retrospective8 months, 16 months53OR time equivalent between pTLIF and mini-open TLIF
Blood loss and postoperative pain reduced reduced in pTLIF

Villavicencio et al. (2010) [8]Retrospective37.5 months63 and 76 patientsMean blood loss lower in MI-TLIF
Mean duration of hospital stay shorter in MI-TLIF
Rate of neurological deficit was greater in the MI-TLIF group

Schizas et al. (2009) [5]Prospective22 months (MI)
24 months (O)
36 patients
(O = 18, MI = 18)
MI-TLIF: decreased blood loss, shorter hospital stay, and decreased pain
Steeper learning curve in MI-TLIF

Dhall et al. (2008) [4]Retrospective24 months (MI)
34 months (O)
21 (MI)
21 (O)
MI-TLIF: less blood loss, shorter LOS

Jang and Lee (2005) [13]Pilot30 months100 consecutive patientsSignificant reduction in pain, ODI, and TIS
Improvement in lordosis from 2° to 9°, anterior disc height 6 to 14 mm, and posterior disc height from 4 to 8 mm

Peng et al. (2009) [3]Prospective6 months, 2 years29 (MI), 29 (O)MI-TLIF: fluoroscopic time increased, longer operative times, less blood loss, decreased morphine use, and decreased LOS

Beringer and Mobasser (2006) [15]Prospective6 months8All had solid bone fusions

Park and Foley (2008) [16]RetrospectiveMinimum 24 months,
Mean 35 months
40Mean ODI 55→16 post-op
Mean leg and back pain VAS 65 and 52, improving to 8 and 15
Reduction of spondylolisthesis was achieved in all cases, with a mean decrease in forward translation of 76%

Deutsch and Musacchio (2006) [11]Prospective6–12 months2085% had >20 point reduction in ODI
ODI 57→25
VAS 8.3→1.4

Jang and Lee (2005) [13]Prospective19 months23NRS back pain 7.5→2.3
NRS leg pain 7.4→0.7
Mean ODI 33.1→7.6

Isaacs et al. (2005) [6]Retrospectiven/a20METLIF: less blood loss, less postoperative wound drainage, no dural violation, less pain medication, and shorter LOS

Shunwu et al. (2010) [9]Prospective cohort study24–42 months32 (MI), 30 (O)MI: reduced blood loss, les postoperative back pain, lower serum creatine kinase, shorter time to ambulation, and shorter LOS

Wang et al. (2010) [7]ProspectiveMinimum 13-month follow-upMI = 42, O = 43MI: reduced blood bloss, less postoperative back pain, shorter LOS, greater radiation time

Foley et al. (2003) [2]Retrospective12–20 months, mean 22 months39 patientsTwenty-six had excellent outcomes and 12 had good ones, as determined by the modified MacNab criteria

Schwender et al. (2005) [14]Retrospective22.6 mean follow-up49 patientsEstimated blood loss of 140 mL, mean length of hospital stay 1.9 days, and all 45 patients presenting with preoperative radiculopathy had resolution of symptoms

Dong et al. (2008) [12]Retrospective38.6 mean follow-up27 patientsSolid fusion in 77.8% of patients, clinical success achieved in 88.9% of cases

Anand et al. (2006) [17]Prospective30100Improvement in VAS, ODI, TIS, and NRS for back, 99% fusion