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Spine (Phila Pa 1976) ; 39(3): E191-8, 2014 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-24150437

RESUMEN

STUDY DESIGN: This was a prospective clinical study that took place in an outpatient spine clinic. OBJECTIVE: To demonstrate the short-/long-term outcomes from a large cohort of patients undergoing minimally invasive transforaminal lumbar interbody fusion (MITLIF). SUMMARY OF BACKGROUND DATA: Long-term prospective outcomes in patients undergoing minimally invasive spinal fusion for debilitating back pain has not been well studied. METHODS: Presenting diagnosis was determined from clinical findings and radiographical (radiograph, magnetic resonance image, computed tomographic scan) evaluations preoperatively. Patients were assessed with outcome measures preoperatively, and postoperatively at 2 weeks, 3 months, 6 months, 12 months, 24 months, and annually 2 to 7 years (mean follow-up: 47 mo) final follow-up. The rate of postoperative complications and reoperations at the initial level of MITLIF and adjacent level(s) were followed. Fusion rates were assessed blinded and independently by radiograph. RESULTS: Visual analogue scale scores decreased significantly from 7.0 preoperatively to 3.5 at mean 47-month follow-up. Oswestry Disability Index scores declined from 43.1 preoperatively to 28.2 at mean 47-month follow-up. Short-Form 36 mental component scores increased from 43.8 preoperatively to 49.7 at 47-month follow-up. Short-Form 36 physical component scores increased from 30.6 preoperatively to 39.6 at 47-month follow-up (P < 0.05). CONCLUSION: This prospectively collected outcomes study shows long-term statistically significant clinical outcomes improvement after MITLIF in patients with clinically symptomatic spondylolisthesis and degenerative disc disease with or without stenosis. MITLIF resulted in a high rate of spinal fusion and very low rate of interbody fusion failure and/or adjacent segment disease requiring reoperation while reducing postoperative complications. LEVEL OF EVIDENCE: 3.


Asunto(s)
Degeneración del Disco Intervertebral/psicología , Degeneración del Disco Intervertebral/cirugía , Vértebras Lumbares/cirugía , Procedimientos Quirúrgicos Mínimamente Invasivos/psicología , Calidad de Vida/psicología , Fusión Vertebral/psicología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Degeneración del Disco Intervertebral/diagnóstico por imagen , Vértebras Lumbares/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos/tendencias , Estudios Prospectivos , Radiografía , Fusión Vertebral/tendencias , Factores de Tiempo , Resultado del Tratamiento , Adulto Joven
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