Minimally Invasive Tlif Compared To Open Tlif For Acute Cauda Equina Syndrome: A Retrospective Single Center Study With Long-Term Follow-Up.

Overview

STUDY DESIGN: Retrospective study. OBJECTIVES: To compare the clinical efficacy and post-operative MRIs of minimally invasive (MI) and open (O) transforaminal lumbar interbody fusion (TLIF) in the treatment of CES caused by lumbar disc herniation. METHODS: 116 patients with CES associated with disc herniation underwent decompression and stabilization surgery from January 2005 to January 2020 in a single-center, and data were collected and retrospectively analyzed. The patients were divided into the Open-TLIF and the MI-TLIF group. The perioperative clinical data and MRI assessment were used to assess the efficacy of the respective surgical methods pre-operatively and with a minimum follow-up of 30 months. RESULTS: As expected, the O-TLIF group had statistically significantly longer surgery times and hospital stay, more bleeding and perioperative surgical complications than the MI-TLIF group. At a minimum follow-up period of 30 months, the MI-TLIF group had significantly better ODI, VAS, SF-36 and neurological CES symptoms than the Op-TLIF group. The postoperative MRIs revealed a statistically significant difference in the multifidus muscle area in MI group compared to the Open group. CONCLUSION: In patients with acute CES caused by disc herniation, minimally invasive TLIF, with decreased disruption of paravertebral tissues and postoperative pain syndrome, results in earlier mobilization and rehabilitation with better long-term clinical outcomes compared to open TLIF.