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Year : 2020  |  Volume : 4  |  Issue : 2  |  Page : 82-86

Open versus Minimally invasive transforaminal lumbar interbody fusion: Intermediate outcomes in overweight and obese patients

1 Department of Surgery, Division of Orthopedic, Ministry of the National Guard-Health Affairs; King Abdullah International Medical Research Center; King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
2 College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia

Correspondence Address:
Dr. Muath M Alswat
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, P.O. Box 9515, Mail Code: 6556, Jeddah 21423
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmsr.jmsr_9_20

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Objectives: To compare the intermediate results between minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and open approach in obese and overweight patients. Methods: A retrospective cohort study was conducted in which all cases of obese (body mass index [BMI] ≥30) and overweight (BMI ≥25) patients who had TLIF done in KAMC-NGHA, Jeddah, from January 2009 to December 2018 were reviewed. Patients were divided into two groups, namely MIS-TLIF and OPEN-TLIF and were compared in operative time, blood loss, length of hospitalization (LOH), decrease in hemoglobin, time before ambulation (TBA), and postoperative medium-term function using the Oswestry Disability Index (ODI). Results: Sixty-three MIS-TLIF and 41 Open-TLIF patients were included in the study. BMI for the open group was 31.5 kg/m2 and 33.2 kg/m2 for the MIS group. Blood loss was 175 ml for MIS-TLIF and 414.89 ml for OPEN-TLIF (P = 0.004). LOH was 4.60 days for MIS-TLIF and 8.29 days for OPEN-TLIF (P = 0.018). TBA was 1.86 days for MIS-TLIF and 3.60 days for OPEN-TLIF (P = 0.022). Operative time was 3.96 h for MIS-TLIF and 4.47 h for OPEN-TLIF (P = 0.56). The decrease in hemoglobin was 1.13 g/dl for MIS-TLIF and 1.61 g/dl for OPEN-TLIF (P = 0.435). ODI score was 25.57 points for MIS-TLIF and 19.67 points for OPEN-TLIF (P = 0.767). Conclusion: The results in MIS-TLIF are comparable with OPEN-TLIF in terms of functional outcomes. The advantages of MIS-TLIF are lesser blood loss, shorter hospital stay, and early mobilization; therefore, it is an attractive alternative for OPEN-TLIF in obese and overweight patients. However, large randomized studies are still needed.

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