Objective: To study the short-term clinical outcome of transforaminal lumbar interbody fusion (TLIF) by minimally invasive approach in the treatment of simple foraminal stenosis (SFS).
Methods: Thirty four cases (M: F = 19: 15) diagnosed with SFS from January. 2007 to March. 2009 were included. Age ranged from 47 to 62 (mean: 57) years old. Patients generally had degenerative changes and decreased disc height on X-ray films at the indexed level. No stenosis within the spinal canal was found on myelograph and CTM. Sagittal images of MRI usually demonstrated narrowed foramina. Selective radiculograph and radicular blocking was used to make the definite diagnosis and to locate the involved nerve root. Double paramedian intermuscular approaches were adopted in all cases. Minimally invasive retractor systems, such as X-Tube and Pipeline etc., were used to facilitate the exposure, pedicle screw instrumentation and TLIF.
Results: The average operation time was 2.76 hours. The average blood loss was 387.16 ml. All patients were encouraged to ambulate 2-3 days post-operation. The incisions healed uneventfully. At the final follow-up, instrumentations were maintained in an excellent position in all cases and JOA score improved by 31.14%.
Conclusions: TLIF by minimally invasive approach is an effective method in treating patients with lumbar foraminal stenosis. The short-term clinical outcomes are satisfactory. This approach may avoid the injuries to paraspinal muscles, posterior ligaments, dura and nerve root of the uninvolved side.