Spine recently published an article examining the learning curve for minimally invasive transforaminal lumbar interbody fusion.
The researchers examined the first 90 single-level MIS TLIF, using a consistent technique and spinal, instrumentation, performed by a single surgeon. The researchers found:
1. The surgeon's learning curve for MIS TLIF was achieved on the 44th case. Demographics were similar for the first 44 patients as the latter 46 patients.
2. There were three variables that showed difference between the first group of patients and the last group of patients:
• Average operative duration
• Fluoroscopy duration
• Patient-controlled analgesia usage
3. At the final follow-up, the three clinical outcome parameters that were different between the two groups were:
• VAS scores for back pain
• VAS score for leg pain
• Neurogenic symptom scores
4. Both groups had similar fusion rates. "In our study, technical proficiency in MIS TLIF was achieved after 44 surgeries, and the latter patients benefited from shorter operative duration and radiation, less pain and more relief in their back, leg and neurogenic symptoms," the article authors concluded.
5. None of the complications for MIS TLIF were converted into open TLIF. The complications in the early group were incidental deurotomy and asymptomatic cage migrations. The complication in the latter group was an asymptomatic cage migration.