Long-Term Health-Related Quality of Life Outcomes after Minimally Invasive Transforaminal Lumbar Interbody Fusion: Analysis of 318 Consecutive PatientsKeywords: quality of life, outcome, survey, lumbar spine, spinal fusionInteractive Manuscript
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What is the background behind your study?
What is the purpose of your study?
Minimally-invasive transforaminal lumbar interbody fusion (MITLIF) is commonly performed, but long-term prospective quality of life outcomes are lacking.
Describe your patient group.
318 patients (63 years, 19-94) who underwent MITLIF with percutaneous pedicle screw instrumentation were followed long-term (range, 2-7 years). Patients presented with spondylolisthesis (n=236, 74%), and degenerative disc disease (n=82, 26%). 196 women and 122 men were treated.
Describe what you did.
Oswestry Disability Index (ODI), Short Form-36 (SF36) Physical Component Scores (PCS) and Mental Component Scores (MCS) were recorded prospectively . Blood loss, length of stay, and adjacent segment disease requiring reoperation were noted.
Describe your main findings.
Levels fused included L1-2 (n=3, 1%), L2-3 (n=19, 6%), L3-4 (n=34, 11%), L4-5 (n=163, 51%), L5-S1 (n=89, 28%), or multiple levels (n=10, 3%). Mean blood loss was 128.4 mL. Mean hospital stay was 4.37 days. ODI scores declined from 44.1 preoperatively to 28.1 (p<0.05) at one year, and 30.4 (p<0.05) during long-term follow-up. SF36 physical component scores (PCS) increased from 30.3 preoperatively to 39.6 (p<0.05) at one year and 38.7 (p<0.05) during long-term follow-up. SF36 mental component scores increased from 43.7 preoperatively to 48.5 (p<0.05) at one year and 49.1 (p<0.05) during long-term follow-up. Re-operation rate for adjacent level disease was less than 2% for the long-term follow-up period.
Describe the main limitation of this study.
This is a retrospective study.
Describe your main conclusion.
This prospective study shows statistically significant health care outcome improvements after MITLIF.
Describe the importance of your findings and how they can be used by others.
These improvements are durable and remain statistically significant over the long-term, up to seven years. In addition to minimal blood loss and short hospital stay, there was a very low rate of adjacent segment disease requiring re-operation.
Minimally-invasive transforaminal lumbar interbody fusion (MITLIF) is commonly performed, but long-term prospective quality of life outcomes are lacking.
318 patients (63 years, 19-94) who underwent MITLIF with percutaneous pedicle screw instrumentation were followed long-term (range, 2-7 years). Patients presented with spondylolisthesis (n=236, 74%), and degenerative disc disease (n=82, 26%). 196 women and 122 men were treated.
Oswestry Disability Index (ODI), Short Form-36 (SF36) Physical Component Scores (PCS) and Mental Component Scores (MCS) were recorded prospectively . Blood loss, length of stay, and adjacent segment disease requiring reoperation were noted.
Levels fused included L1-2 (n=3, 1%), L2-3 (n=19, 6%), L3-4 (n=34, 11%), L4-5 (n=163, 51%), L5-S1 (n=89, 28%), or multiple levels (n=10, 3%). Mean blood loss was 128.4 mL. Mean hospital stay was 4.37 days. ODI scores declined from 44.1 preoperatively to 28.1 (p<0.05) at one year, and 30.4 (p<0.05) during long-term follow-up. SF36 physical component scores (PCS) increased from 30.3 preoperatively to 39.6 (p<0.05) at one year and 38.7 (p<0.05) during long-term follow-up. SF36 mental component scores increased from 43.7 preoperatively to 48.5 (p<0.05) at one year and 49.1 (p<0.05) during long-term follow-up. Re-operation rate for adjacent level disease was less than 2% for the long-term follow-up period.
This is a retrospective study.
This prospective study shows statistically significant health care outcome improvements after MITLIF.
These improvements are durable and remain statistically significant over the long-term, up to seven years. In addition to minimal blood loss and short hospital stay, there was a very low rate of adjacent segment disease requiring re-operation.
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