Minimally invasive vs. open spinal fusion — TLIF & PLIF: 6 things to know


A study published in Spine compares the effectiveness and economic evaluations of open and minimally invasive posterior or transforaminal lumbar interbody fusion.

The researchers examined the Medline, EMBASE, Web of Science and Cochrane from the database' inception to September 2015 to include studies comparing minimally invasive and open TLIF and PLIF for degenerative lumbar conditions.


There were 45 studies included in the review with 3,472 subjects undergoing the minimally invasive procedures and 5,925 undergoing the open procedure. Here are six key findings;


1. There weren't significant differences in the operative time between the minimally invasive and open procedures.


2. Patients undergoing minimally invasive fusions had lower blood loss than the open procedure group — 88.7 percent lower.


3. The hospital stays among the minimally invasive group were 64 percent shorter than hospital stays in the open group.


4. There wasn't a difference in the visual analog scale, Oswestry Disability Index, SF-36, SF-12 or EQ-5D scores between the two techniques at the intermediate or long-term follow-ups.


5. The complication rates and fusion rates were equivalent between the open and minimally invasive fusions.


6. The economic analyses showed minimally invasive fusion procedures had 2.5 percent to 49.3 percent cost-savings. "Increasing economic data suggest both direct and indirect cost-savings in favor of MIS fusion," concluded the study authors.


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