Prospective Randomized Comparison of Minimally Invasive Tlif versus Open Tlif: Clinical Effectiveness and Restoration of Working Capacity in Railway Workers
Byvaltsev V.A. Kalinin A.A. Pestryakov Y.Y. Hozeev D.V. Kundubayev R.A. Biryuchkov M.Y. Riew K.D.
April 2025SAGE Publications Ltd
Global Spine Journal
2025#15Issue 31508 - 1516 pp.
Study Design: Randomized Clinical Trial. Objective: To compare the clinical efficacy and restoration of working capacity after MI (minimally invasive)-TLIF and O (open)-TLIF in railway workers with lumbar degenerative disease. Methods: 83 patients, who were indicated for two-level lumbar decompression and fusion were randomly assigned to one of two groups: group 1 (n = 44) had MI-TLIF procedure and group 2 (n = 39) had O-TLIF procedure. The functional status was assessed using SF-36, ODI and VAS for back and leg pain, preoperatively, at discharge, and at 3, 6, and 12 months postoperatively. MRI and CT were obtained 1-year follow-up. The percentage of patients who returned to work at 1-year, work intensity and the time to return to work post-operatively were analyzed. Results: At 1-year follow-up, the MI-TLIF group had significantly better ODI, VAS and SF-36 scores compared to the O-TLIF group. The postoperative MRIs revealed a statistically significantly less multifidus muscle atrophy in the MI group compared to the Open group. At 1-year follow-up, a comparable fusion ratio between MI group and Open group was recorded. After MI-TLIF procedure, depending on the workload, patients had a statistically significantly earlier return to work (P <.05) and statistically significantly higher return to work rate compared with the O-TLIF group (P <.05). Conclusions: The use of two-level MI-TLIF in railway workers has made it possible to significantly improve long-term clinical results, reduce the risk of surgical complications, muscle atrophy and time to return to work compared to O-TLIF.
decompression-stabilization interventions , lumbar degenerative diseases , minimally invasive spinal surgery , minimally invasive-TLIF , open TLIF , return to work , workload intensity
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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
Department of NeurosurgeryWest Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
Department of Orthopedic Surgery, Columbia University, NY, United States
Department of Neurological Surgery, Weill Cornell Medical College, New York, NY, United States
Department of Neurosurgery
Department of Neurosurgery
Department of Traumatology
Department of NeurosurgeryWest Kazakhstan Marat Ospanov Medical University
Department of Orthopedic Surgery
Department of Neurological Surgery
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