Friday, September 28, 2018 1:00 PM–2:30 PM abstracts: achieving lumbar interbody fusion

BACKGROUND CONTEXT Several studies have compared Open Transforaminal Lumbar Interbody Fusion (TLIF) to minimally invasive (MIS) TLIF, however the different approaches for MIS technique including Wiltse and limited midline exposure have not previously been compared. PURPOSE We analyzed the perioperative and postoperative outcomes of patients who underwent open TLIF (O-TLIF), midline MIS approach TLIF (M-TLIF) with percutaneous pedicle or cortical screws, and bilateral Wiltse approach MIS TLIF (W-TLIF). STUDY DESIGN/SETTING Retrospective cohort study at a single institution. PATIENT SAMPLE Patients undergoing a single-level primary TLIF between 2012 and 2017. OUTCOME MEASURES Estimated blood loss (EBL), length of stay (LOS), intraoperative and postoperative complication rate, reoperation rate, readmission rate. METHODS Single-level primary TLIF cases were categorized as Open (traditional midline exposure including lateral exposure of transverse processes (TPs)), Midline MIS (limited midline exposure without TP exposure), or bilateral paramedian Wiltse approach cases. Patients were assessed for EBL, operative time, LOS, fluoroscopy time, complications and readmission status up to 90 days postoperatively. Differences between groups were assessed by ANOVA. RESULTS A total of 255 patients underwent one-level primary TLIF (116 O-TLIF, 29 M-TLIF, 110 W-TLIF). There was no difference in age, gender, ASA or BMI between groups. On ANOVA analysis, W-TLIF had the lowest EBL (195mL vs. 321mL M-TLIF vs. 499mL O-TLIF, p= CONCLUSIONS In comparing different TLIF approaches, the minimally invasive paramedian Wiltse approach demonstrates the lowest EBL, LOS, readmission rates and complications, but longer fluoroscopy times when compared to the traditional open approach.