“Does size matter?”A comparison of balloon-assisted less-invasive vs conventional retroperitoneal approach for anterior lumbar interbody fusion

This is a case-series comparison of two approaches to anterior lumbar interbody fusion. A conventional open approach (COA) was compared with a balloon-assisted minimally invasive approach (BMI). Outcome measures included operating time, blood loss and complications. Secondary outcome measures included analgesia requirements, time to mobilization and inpatient stay. There were 17 females (7 COA, 10 BMI) and 18 males (9 COA and 9 BMI). Forty-five discs (21 COA, 24 BMI) in total were fused in 35 patients. There were significant differences (in favour of the BMI) in the overall operating time between the COA and the BMI, and the single level COA and the BMI. There was no inter-group difference in the PCA requirements either overall or between one or two-level operations. The less invasive approach did have a benefit in earlier mobilization of the single-level fusions.