The Complication Rate of Mini Open Transforaminal Lumbar Interbody Fusion: Single Institution Experience; A Retrospective Case Study

Abstract Background: The mini-open TLIF and other minimally invasive approaches introduced for treating lumbar degener-ative disk disease and instability achieving high success rate and safety as the conventional approaches, with less soft tissue damage, minimal blood loss and less hospital stay. Aim of Study: The aim of this study is to demonstrate the complication rate and surgical technique ofthe mini-open transforaminal approach for lumbar interbody fusion (TLIF) combine with transpedicular screw fixation. Patients and Methods: A retrospective study was conducted on 28 patients underwent Mini-open TLIF combined with trans-pedicular screw fixation for grade one or grade two spondylolisthesis and degenerative disk disease from 2012 to 2014. Two paramedian approaches 4cm for each were done for insertion of the pedicular screws with unilateral TLIF cage insertion with autologous bone graft. Decompression was done either unilateral or bilateral according to the patient side of radiculopathy. Sixteen patients (57.2%) were degenerative spondylolisthesis, 7 patients (25%) were diagnosed as isthmic type spondylolisthesis and 5 patients (17.8%) was diagnosed as degenerative disk disease, two of them (7.1%) had previous operation at the same level. Twenty patients (71.4%) were operated at the L4/5 level and eight patients (28.6%) at the L5/S 1 level. Results: All patients were able to ambulate next day of surgery. We had one case with transient weakness, 2 cases of screw malposition without clinical manifestations, and one case of infection. The mean estimated blood loss was 251.79cc. The average hospital stay was 4.14 days. The average follow-up was 9 months. Conclusions: The mini-open TLIF approach is an efficient and safe approach for treating instability and degenerative diseases of the lumbar spine. The outcome was encouraging and it may be an operation of choice for lumbar spinal fusion in selected patients with a good safety profile.