OBJECTIVE To evaluate clinical and radiological outcomes between bilateral decompression using over-the- top technique (Group 1) and unilateral decompression (Group 2) in patients with claudication who underwent minimally invasive transforaminal… Click to show full abstract
OBJECTIVE To evaluate clinical and radiological outcomes between bilateral decompression using over-the- top technique (Group 1) and unilateral decompression (Group 2) in patients with claudication who underwent minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). METHODS We enrolled patients with claudication who underwent MIS-TLIF from January 2017 to June 2019. Visual analog scale (VAS), Oswestry Disability Index (ODI) scores, walking distance and perioperative outcomes were compared between groups. Preoperative and 3-month postoperative magnetic resonance imaging scan assessed changes in canal cross-sectional area, foraminal height, and lateral recess area. RESULTS Sixty-five consecutive patients with at least one year of follow-up were enrolled. VAS and ODI scores were not significantly different between groups (VAS and ODI, respectively, at 1-month follow-up: P=0.62, 0.88; 3-month follow-up: P=0.96, 0.53; 6-month follow-up: P=0.10, 0.85; and 12-month follow-up: P=0.10, 0.66). Operative time and blood loss between groups was not found statistically significant (P=0.43 and p=0.55). There was also no difference in the length of hospital stay (P=0.24). Canal dimensions increased in each group without significant differences between groups (cross-sectional area: P=0.92; foraminal height [approach and contralateral side, respectively]: P=0.62, 0.66; and lateral recess area [approach and contralateral side, respectively]: P=0.68, 0.50). CONCLUSIONS Unilateral approach with ipsilateral side direct decompression and contralateral indirect decompression in MIS-TLIF is sufficient for early clinical improvement in patients with claudication.
               
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