Chan Wb Weng MD
Department of Orthopedic Surgery
Singapore General Hospital
Singapore
Wai M. Yue M.D.
Department of Orthopedic Surgery
Singapore General Hospital
Singapore
Seang B. Tan M.D.
Department of Orthopedic Surgery
Singapore General Hospital
Singapore
Citation: C. Weng, W. Yue & S. Tan : Clinical And Radiological Outcomes Of Minimally Invasive Versus Open Transforaminal Lumbar Interbody Fusion. The Internet Journal of Minimally Invasive Spinal Technology. 2009 Supplement II - to IJMIST Vol III No 4
Abstract
Study Design: Prospective study Objective: Comparison of clinical and radiological outcomes of minimally invasive (MIS) versus open transforaminal lumbar interbody fusion (TLIF). Summary of Background Data: Open TLIF has been performed for many years with good results. MIS TLIF techniques have recently been introduced with the aim of smaller wounds and faster recovery. Methods: From 2004 - 2006, 29 MIS TLIF were matched paired with 29 Open TLIF. Patient demographics and operative data were collected. Clinical assessment in terms of NASS, SF-36 and VAS scores were performed preoperatively, 6 month and 2 year postoperatively. Fusion rates based on Bridwell grading were assessed at 2 years. Results: The mean age for MIS and Open procedures were 54.1 and 52.5 years respectively. There were 24 females and 5 males in both groups. Fluoroscopic time (MIS: 105.5 seconds, Open: 35.2 seconds, p<.05) and operative time (MIS: 216.4 minutes, Open: 170.5 minutes, p<.05) were longer in MIS cases. There was less blood loss in MIS (150ml) versus Open (681ml) procedures (p<.05). The total morphine used for MIS cases (17.4mg) was less compared to Open (35.7mg, p<.05). MIS (4 days) patients have shorter hospitalisation compared to Open (6.7 days, p<.05). Both MIS and Open groups showed significant improvement in back pain and lower limb symptoms (NASS and VAS scores, p<.05) and Quality of Life scores (SF-36, p<.05) at 6 months and 2 years but there was no significant difference between the two groups. 80% of MIS and 86.7% of Open TLIF levels achieved Grade 1 fusion (p>0.05). Conclusion: MIS TLIF has similar good long term clinical outcomes and high fusion rates of OPEN TLIF with the additional benefits of less initial postoperative pain, early rehabilitation, shorter hospitalization and fewer complications. Curriculum Vitae Name: Chan Wearn Benedict Peng Sex: Male Qualification FRCS (Orthopaedics) (Edinburgh) 2006 MMed (Orthopaedics) 2002 MB ChB (Honours) 1996 Education University of Leeds Medical School 1991 - 1996 Hwa Chong Junior College 1989 - 1990 The Chinese High School 1985 - 1988 St. Andrew's Primary School 1979 - 1984 Medical Training Clinical Spine Fellowship - Hospital for Joint Diseases (New York, USA) 2007 Spine Fellowship (Observer) - Hospital for Special Surgery (New York, USA) 2007 Advanced Surgical Trainee (Orthopaedics) 2002-2006 Basic Surgical Trainee - 2000-2002 Awards AO Spine Traveling Fellowship 2007 SGH Service with A Heart Award 2006 Garland Prize in Clinical Neurology 1996 Tetley and Lupton Scholarship (University of Leeds) 1991-96 Medical Insurance Agency Charity Award - for Elective Programme 1995 Lady Moynihan Award - for Elective Research 1995 Infirmary Prize - for Best Performance in 2nd MB 1993 Biochemistry Prize - for Best Performance in Biochemistry 1993 Shuttleworth Prize - for Best Performance in Anatomy 1993 Crabtree Prize - for Outstanding Academic Performance 1992 Academic Position Clinical Tutor - National University of Singapore Clinical Supervisor - Singapore General Hospital Orthopaedic Department Professional Affiliations Member of North American Spine Society Since 2006 Member of AOSpine Since 2006 Member of Asia-Pacific Orthopaedic Association Since 2006 Member of Singapore Orthopaedic Association Since 2006 Member of Singapore Medical Association Since 1997
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