Ten-Year Outcomes of Minimally Invasive Versus Open Transforaminal Lumbar Interbody Fusion in Patients With Single-Level Lumbar Spondylolisthesis

Study Design. A retrospective observational study. Objective. This study investigated the clinical and radiological results of minimally invasive (MI) versus open transforaminal lumbar interbody fusion (TLIF) in patients with single-level lumbar spondylolisthesis over a 10-year period. Summary of Background Data. Few studies have compared 10-year follow-up outcomes between MI-TLIF and open TLIF. Methods. We retrospectively collected the outcome data of patients with single-level lumbar spondylolisthesis who underwent TLIF procedures using an MI ( n  = 108) or open ( n  = 53) approach. Fifty-two (48%) and 31 (58%) patients in the MI-TLIF and open TLIF groups, respectively, completed the 10-year follow-up. A primary clinical outcome included the Oswestry Disability Index (ODI) as well as visual analog scale (VAS) scores for back and leg pain at baseline and at 2, 5, and 10 years postoperatively. The radiographic fusion rate and incidence of secondary surgery due to adjacent segment disease were assessed at 2, 5, and 10 years postoperatively. Results. Intraoperative blood loss and length of hospitalization were significantly lower in the MI-TLIF group than in the open TLIF group. At 2 years postoperatively, the ODI and VAS scores for back and leg pain were significantly lower in the MI-TLIF group than in the open TLIF group. No significant differences were found in VAS scores for back and leg pain or ODI scores between the two groups at 10 years postoperatively. Radiographic fusion rates and prevalence of secondary surgery for adjacent segment disease were not significantly different between the groups at 10 years postoperatively. Conclusion. Efficacy of MI-TLIF for patients with single-level lumbar spondylolisthesis is comparable to that of open TLIF over 10-years. However, MI-TLIF may have superior perioperative recovery and 2-year postoperative functional outcomes than open TLIF. Level of Evidence: 3