Minimally Invasive Tlif Compared To Open Tlif For Acute Cauda Equina Syndrome: A Retrospective Single Center Study With Long-Term Follow-Up

Retrospective study. To compare the clinical efficacy and post-operative MRIs of minimally invasive (MI) and open (O) transforaminal lumbar interbody fusion (TLIF) in the treatment of CES caused by lumbar disc herniation. 116 patients with CES associated with disc herniation underwent decompression and stabilization surgery from January 2005 to January 2020 in a single-center, and data were collected and retrospectively analyzed. The patients were divided into the Open-TLIF and the MI-TLIF group. The perioperative clinical data and MRI assessment were used to assess the efficacy of the respective surgical methods pre-operatively and with a minimum follow-up of 30 months. As expected, the O-TLIF group had statistically significantly longer surgery times and hospital stay, more bleeding and perioperative surgical complications than the MI-TLIF group. At a minimum follow-up period of 30 months, the MI-TLIF group had significantly better ODI, VAS, SF-36 and neurological CES symptoms than the Op-TLIF group. The postoperative MRIs revealed a statistically significant difference in the multifidus muscle area in MI group compared to the Open group. In patients with acute CES caused by disc herniation, minimally invasive TLIF, with decreased disruption of paravertebral tissues and postoperative pain syndrome, results in earlier mobilization and rehabilitation with better long-term clinical outcomes compared to open TLIF.