Minimally Invasive Transforaminal Lumbar Interbody Fusion with Percutaneous Bilateral Pedicle Screw Fixation for Lumbosacral Spine Degenerative Diseases. A Retrospective Database of 40 Consecutive Cases and Literature Review

approach (4). In 2002, Foley and Lefkowitz enhanced the same concept by means of the implementation of a minimally invasive TLIF (MI-TLIF) with the goal to reduce tissue damages, at the same time achieving both neural decompression and adequate interbody fusion (2). █ INTRODUCTION Minimally invasive surgery has gained popularity over the last decades. In 1982, Harms and Rolinger developed the transforaminal lumbar interbody fusion (TLIF) technique aimed to reduce the amount of thecal sac and nerve root retraction thanks to the laterality of the AIm: To report our results about minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) with bilateral pedicle screw fixation, in patients with degenerative lumbosacral spine disease. To describe the indications, surgical technique and results of a consecutive series of 40 patients who had undergone MI-TLIF. Despite the limited number of clinical studies, published data suggest tremendous potential advantages of this technique. mATERIAl and mEThODS: Forty patients with radiological findings of degenerative lumbosacral spine disease had undergone MI-TLIF between July 2012 and January 2015. Clinical outcomes were assessed by means of Oswestry Disability Index (ODI) and Health Survey Scoring (SF36) before surgery and at first year follow-up. Furthermore, the following parameters were retrospectively reviewed: age, sex, working activity, body mass index (BMI), type of degenerative disease, number of levels of fusion, operative time, blood loss, length of hospital stay. RESUlTS: Average operative time was 230 minutes, mean estimated blood loss 170 mL, average length of hospital stay 5 days. The ODI improved from a score of 59, preoperatively, to post-operative score of 20 at first year follow-up. Average SF36 score increased from 36 to 54 (Physical Health) and from 29 to 50 (Mental Health) at first year outcome evaluation. CONClUSION: MI-TLIF with bilateral pedicle screw fixation is an excellent choice for selected patients suffering from symptomatic degenerative lumbosacral spine disease, especially secondary to recurrent disc herniations. KEywORDS: Transforaminal lumbar interbody fusion, Minimally invasive spine surgery, Pedicle screw fixation, Lumbosacral spine degenerative disease, Percutaneous surgery