Evaluation of Minimally Invasive TLIF in Degenerative Lumbar Disorders: A prospective study

Background: Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has been developed to achieve spinal decompression and stable fusion with minimal soft-tissue trauma. This study evaluates the clinical, functional, and radiological outcomes of MIS-TLIF for degenerative lumbar spine disorders. Patients and methods: A prospective study was conducted. Inclusion criteria comprised degenerative spondylolisthesis, disc disease, or recurrent lumbar disc herniation. Patients with severe osteoporosis, infection, tumor, or fixed deformity were excluded. Operative time, intra-operative blood loss, and fluoroscopy exposure were recorded. Pain and function were assessed using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI), while fusion was evaluated radiographically using the Bridwell Interbody Fusion Grading System (BIFGS). Results: the study included thirty-two patients (19 males, 13 females). The mean age was 58.5 ± 9.1 years. The mean operative time was 186.5 ± 42 min, mean blood loss 278.4 ±72 ml, and mean fluoroscopy time 114 ± 31 sec. The average hospital stay was 1.3 ± 0.4 days. Back VAS improved significantly from 7.9 ± 0.6 preoperatively to 1.6 ± 0.5 at one year (p < 0.001), similarly, Leg VAS decreased from 7.3 ± 0.8 to 1.0 ± 0.4 (p <0.001). ODI improved from 51.8 ± 6.4 % to 13.8 ± 3.8 % (p < 0.001). Radiological fusion (Grades І-ІІ) was achieved in 97 % of patients at 12 months. Conclusion: MIS-TLIF is a safe and effective procedure for degenerative lumbar disease, providing substantial pain relief, functional recovery, and high fusion rates, despite longer operative time and more fluoroscopy exposure.