Clinical evaluation of a modified minimally invasive transforaminal lumbar interbody fusion approach in single-level lumbar spine revision: A retrospective cohort study

This study aimed to evaluate the clinical outcomes and safety of a modified minimally invasive transforaminal lumbar interbody fusion approach incorporating a quadrant channel and medially shifted working corridor in patients undergoing single-level lumbar spine revision surgery. This retrospective cohort included 50 patients who underwent single-level lumbar revision surgery at the Department of Orthopedics, Affiliated Renhe Hospital of China Three Gorges University, between January 2020 and December 2022. All patients had previously undergone percutaneous endoscopic transforaminal discectomy and subsequently developed recurrent lumbar disc herniation at the same spinal segment. Surgical parameters assessed included operative time, intraoperative blood loss, and postoperative drainage volume. Clinical outcomes were measured using the Visual Analog Scale and the Oswestry Disability Index. Interbody fusion was evaluated using thin-slice lumbar computed tomography at the final follow-up. The mean operative duration was 104 ± 12.1 minutes. The average intraoperative blood loss measured 316 ± 12.6 mL, with a postoperative drainage volume of 132 ± 8.3 mL. One patient developed transient ipsilateral nerve root palsy during the first postoperative week, and delayed wound healing was observed in 3 patients. Visual Analog Scale scores decreased significantly, from a preoperative mean of 8.09 ± 0.30 to 2.18 ± 0.23 at 4 weeks postoperatively, and further to 0.95 ± 0.16 at the final follow-up (P < .001). Oswestry Disability Index scores improved from 38.75 ± 1.53 preoperatively to 15.84 ± 0.58 at 4 weeks and 5.57 ± 0.99 at the final follow-up (P < .001). Successful interbody fusion was confirmed in all cases by the final follow-up. The modified minimally invasive transforaminal lumbar interbody fusion technique, employing a quadrant channel and a medially adjusted working corridor, demonstrated satisfactory clinical outcomes and an acceptable complication profile in patients undergoing single-level lumbar revision procedures.