Minimally Invasive Transforaminal Lumbar Interbody Fusion (TLIF) Compared with Open TLIF for Acute Cauda Equina Syndrome: A Retrospective Single-Center Study with Long-Term Follow-Up
Byvaltsev V.A. Kalinin A.A. Shepelev V.V. Pestryakov Y.Y. Aliyev M.A. Riew K.D.
October 2022Elsevier Inc.
World Neurosurgery
2022#166e781 - e789 pp.
Objectives: In a retrospective study, we sought to compare the clinical efficacy and postoperative magnetic resonance imaging (MRI) scans of minimally invasive (MI) and open (O) transforaminal lumbar interbody fusion (TLIF) in the treatment of cauda equina syndrome (CES) caused by lumbar disc herniation. Methods: In total, 116 patients with CES associated with disc herniation underwent decompression and stabilization surgery from January 2005 to January 2020 in a single-center study, and data were collected and retrospectively analyzed. The patients were divided into the O-TLIF and the MI-TLIF group. The perioperative clinical data and MRI assessment were used to assess the efficacy of the respective surgical methods preoperatively and with a minimum follow-up of 30 months. Results: As expected, the O-TLIF group had statistically significantly longer surgery times and hospital stay, more bleeding, and perioperative surgical complications than the MI-TLIF group. At a minimum follow-up period of 30 months, the MI-TLIF group had significantly better Oswestry Disability Index, visual analog scale, and Short-Form-36, and neurologic CES symptoms than the O-TLIF group. The postoperative MRIs revealed a statistically significant difference in the multifidus muscle area in MI group compared with the O group. Conclusions: In patients with acute CES caused by disc herniation, MI-TLIF, with decreased disruption of paravertebral tissues and postoperative pain syndrome, results in earlier mobilization and rehabilitation with better long-term clinical outcomes compared with O-TLIF.
Cauda equina syndrome , Decompression–stabilization interventions , Lumbar disc herniation , MI-TLIF , Minimally invasive spinal surgery , Open TLIF
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Department of Neurosurgery, Irkutsk State Medical University, Irkutsk, Russian Federation
Department of Neurosurgery, Railway Clinical Hospital, Irkutsk, Russian Federation
Department of Traumatology, Orthopedic and Neurosurgery, Irkutsk State Medical Academy of Postgraduate Education, Irkutsk, Russian Federation
Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Department of Orthopedic Surgery, Columbia University, New York, United States
Department of Neurological Surgery, Weill Cornell Medical College, New York, United States
Department of Neurosurgery
Department of Neurosurgery
Department of Traumatology
Asfendiyarov Kazakh National Medical University
Department of Orthopedic Surgery
Department of Neurological Surgery
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