General Session: MIS-1
Presented by: A. Arruda - View Audio/Video Presentation (Members Only)
C. Menezes(1), D. Oliveira(2), R. Falcon(2), R. Porto(2), G. Senna(2), A. Arruda(2), E. Menezes(3)
(1) Lifecenter Hospital/Columna Spine Institute, Belo Horizonte, Brazil
(2) Lifecenter Hospital, Belo Horizonte, Brazil
(3) Columna Spine Institute, Belo Horizonte, Brazil
Objective: The aim of this study was to assess current spinopelvic parameters measured after extreme-lateral interbody fusion (XLIFR) versus minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), in order to compare postoperative results.
Methods: Eighty consecutive patients undergoing single to three level lumbar interbody fusion surgery for common spine degenerative disorders at a single center were recruited to two different groups, according to the surgical technique applied: XLIFR (n=36) x MIS-TLIF (n=44). Postoperative (PO) standing lateral films including all lumbar segments and femoral heads were obtained from all included patients and analysed using NuvamapR software by a single experienced spine surgeon. XLIF and MIS-TLIF patients were compared in terms of the following parameters: age, gender, operated levels (number and location), pelvic incidence (PI), lumbar lordosis (LL), segmental lordosis (SL), L4S1 lordosis, pelvic tilt (PT), sacral slope (SS), and mismatch (PI-LL). Data were registered in a specific database created for the study.
Results: XLIFR and MIS-TLIF groups were similar in terms of age and gender. In XLIFR group (n=36), the following spinopelvic parameters were obtained in average: PI 56,1; LL 53,2; PT 16,7; SS 39,5; mismatch (PI-LL) -2,2. For MIS-TLIF group (n=44): PI 52,6; LL 45,9; PT 19; SS 34,3; mismatch -5,9. A mismatch (PI-LL) greater than 20 degrees was observed in only 7 (8,75%) patients (XLIFR- n=2; MIS-TLIF- n=5). Considering single level interbody fusion and excluding L5S1 level, spinopelvic parameters obtained for XLIFR (n=18) group were: PI 58,3; LL 57,1; PT 16,7; SS 41,8; mismatch -0,61; and for MIS-TLIF (n=19) group were: PI 57,5; LL 46,6; PT 24,1; SS 33,6; mismatch -9,1. LL, PT, SS and mismatch showed statistically significant different values between XLIFR and MIS-TLIF groups.
Conclusion: XLIFR and MIS-TLIF are both adequate surgical techniques for treatment of common spine degenerative disorders, with low risk of decompensation in saggital profile. In this study, XLIFR showed superior efficacy to preserve spinopelvic alignment compared to MIS-TLIF.