Extent of intraoperative muscle dissection does not affect longterm outcomes after minimally invasive surgery versus opentransforaminal lumbar interbody fusion surgery: A prospective longitudinal cohort study

Owoicho Adogwa, Kwame Johnson, Elliot T. Min, Neil Issar, Kevin R. Carr, Kevin Huang, Joseph Cheng

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) versus open TLIF, addressing lumbar degenerative disc disease (DDD) or grade I spondylolisthesis (DS), are associated with shorter hospital stays, decreased blood loss, quicker return to work, and equivalent short- and long-term outcomes. However, no prospective study has assessed whether the extent of intraoperative muscle trauma utilizing creatinine phosphokinase levels (CPK) differently impacts long-term outcomes. Methods: Twenty-one patients underwent MIS-TLIF (n = 14) versus open-TLIF (n = 7) for DDD or DS. Serum CPK levels were measured at baseline, and postoperatively (days 1, 7, and 1.5, 3 and 6 months). The correlation between the extent of intraoperative muscle trauma and two-year improvement in functional disability was evaluated (multivariate regression analysis). Additionally, baseline and two-year changes in Visual Analog Scale (VAS)-leg pain (LP), VAS-back pain (BP), Oswestry Disability Index (ODI), Short-Form-36 (SF-36) Physical Component Score (PCS) and SF-36 Mental Component Score (MCS), and postoperative satisfaction with surgical care were assessed. Results: Although the mean change from baseline in the serum creatine phosphokinase level on POD 1 was greater for MIS-TLIF (628.07) versus open- TLF (291.42), this did not correlate with lesser two-year improvement in functional disability. Both cohorts also showed similar two-year improvement in VAS-LP, ODI, and SF-36 PCS/MCS. Conclusion: Increased intraoperative muscle trauma unexpectedly observed in higher postoperative CPK levels for MIS-TLIF versus open-TLIF did not correlate with any differences in two-year improvement in pain and functional disability.

Original languageEnglish (US)
Pages (from-to)S355-S361
JournalSurgical Neurology International
Volume3
DOIs
StatePublished - Nov 26 2012
Externally publishedYes

Keywords

  • Long-term outcomes
  • Minimally invasive transforaminal lumbar inter body fusion
  • Open-transforaminal lumbar interbody fusion
  • Serum creatine phosphokinase

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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