Does Day of Surgery Affect Hospital Length of Stay and Charges Following Minimally Invasive Transforaminal Lumbar Interbody Fusion?

2018 ◽  
Vol 31 (5) ◽  
pp. E291-E295 ◽  
Author(s):  
Fady Y. Hijji ◽  
Ankur S. Narain ◽  
Brittany E. Haws ◽  
Benjamin Khechen ◽  
Krishna T. Kudaravalli ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Minimally Invasive ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Lumbar Interbody Fusion

scholarly journals Surgical Outcomes for Minimally Invasive vs Open Transforaminal Lumbar Interbody Fusion

Neurosurgery ◽  
2015 ◽  
Vol 77 (6) ◽  
pp. 847-874 ◽  
Author(s):  
Nickalus R. Khan ◽  
Aaron J. Clark ◽  
Siang Liao Lee ◽  
Garrett T. Venable ◽  
Nicholas B. Rossi ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Radiation Exposure ◽  
Interbody Fusion ◽  
Operative Time ◽  
Meta Analysis ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Complication Rates ◽  
Lumbar Interbody Fusion

BACKGROUND: Minimally invasive transforaminal lumbar interbody fusion (TLIF)—or MI-TLIF—has been increasing in prevalence compared with open TLIF (O-TLIF) procedures. The use of MI-TLIF is an evolving technique with conflicting reports in the literature about outcomes. OBJECTIVE: To investigate the impact of MI-TLIF in comparison with O-TLIF for early and late outcomes by using the Visual Analog Scale for back pain (VAS-back) and the Oswestry Disability Index (ODI). Secondary end points include blood loss, operative time, radiation exposure, length of stay, fusion rates, and complications between the 2 procedures. METHODS: During August 2014, a systematic literature search was performed identifying 987 articles. Of these, 30 met inclusion criteria. A random-effects meta-analysis was performed by using both pooled and subset analyses based on study type. RESULTS: Our meta-analysis demonstrated that MI-TLIF reduced blood loss (P < .001), length of stay (P < .001), and complications (P = .001) but increased radiation exposure (P < .001). No differences were found in fusion rate (P = .61) and operative time (P = .34). A decrease in late VAS-back scores was demonstrated for MI TLIF (P < .001), but no differences were found in early VAS-back, early ODI, and late ODI. CONCLUSION: MI-TLIF is associated with reduced blood loss, decreased length of stay, decreased complication rates, and increased radiation exposure. The rates of fusion and operative time are similar between MI-TLIF and O-TLIF. Differences in long-term outcomes in MI-TLIF vs O-TLIF are inconclusive and require more research, particularly in the form of large, multi-institutional prospective randomized controlled trials.

Minimally invasive microendoscopy-assisted transforaminal lumbar interbody fusion with instrumentation

2005 ◽  
Vol 3 (2) ◽  
pp. 98-105 ◽  
Author(s):  
Robert E. Isaacs ◽  
Vinod K. Podichetty ◽  
Paul Santiago ◽  
Faheem A. Sandhu ◽  
John Spears ◽  
...  
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Interbody Fusion ◽  
Pedicle Screws ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Hospital Length Of Stay ◽  
Lumbar Interbody Fusion ◽  
Intraoperative Blood Loss ◽  
Disc Space ◽  
Single Level

Object The authors have developed a novel technique for percutaneous fusion in which standard microendoscopic discectomy is modified. Based on data obtained in their cadaveric studies they considered that this minimally invasive interbody fusion could be safely implemented clinically. The authors describe their initial experience with a microendoscopic transforaminal lumbar interbody fusion (METLIF) technique, with regard to safety in the placement of percutaneous instrumentation, perioperative morbidity, and early postoperative results. Methods The METLIF procedure was performed unilaterally in 20 patients with single-level lumbar spondylolisthesis or pure mechanical back pain with endoscopic assistance, hemilaminectomy, unilateral facetectomy, and microdiscectomy. Two interbody grafts were placed via the lateral exposure of the disc space. Bilateral percutaneous pedicle screws were then inserted. Compared with patients who had undergone single-level posterior LIF at the same institutions, intraoperative blood loss, hospital length of stay (LOS), and postoperative narcotic agent use were significantly lower in the METLIF group. The mean LOS for the percutaneous fusion group was 3.4 days (5.1 days in those who underwent PLIF; p < 0.02). There have been no procedure-related complications in this series to date. Conclusions The METLIF technique provided an option for percutaneous interbody fusion similar to that in open surgery while minimizing destruction to adjacent tissues. This technique was safe and exhibited a trend toward decreased intraoperative blood loss, postoperative pain, total narcotic use, and the risk of transfusion.

The Impact of Comorbidity Burden on Complications, Length of Stay, and Direct Hospital Costs After Minimally Invasive Transforaminal Lumbar Interbody Fusion

Spine ◽  
2019 ◽  
Vol 44 (5) ◽  
pp. 363-368
Author(s):  
Benjamin Khechen ◽  
Brittany E. Haws ◽  
Mundeep S. Bawa ◽  
Dil V. Patel ◽  
Kaitlyn L. Cardinal ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Minimally Invasive ◽  
Interbody Fusion ◽  
Hospital Costs ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Comorbidity Burden ◽  
The Impact

Diabetes Does Not Increase Complications, Length of Stay, or Hospital Costs After Minimally Invasive Transforaminal Lumbar Interbody Fusion

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ankur S. Narain ◽  
Brittany E. Haws ◽  
Nathaniel W. Jenkins ◽  
James M. Parrish ◽  
Andrew M. Block ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Minimally Invasive ◽  
Interbody Fusion ◽  
Hospital Costs ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion

The Effect of Preoperative Medications on Length of Stay, Inpatient Pain, and Narcotics Consumption After Minimally Invasive Transforaminal Lumbar Interbody Fusion

2019 ◽  
Vol 32 (1) ◽  
pp. E37-E42 ◽  
Author(s):  
Brittany E. Haws ◽  
Benjamin Khechen ◽  
Dil V. Patel ◽  
Mundeep S. Bawa ◽  
Jordan A. Guntin ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Minimally Invasive ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion

Cost-effectiveness of minimally invasive midline lumbar interbody fusion versus traditional open transforaminal lumbar interbody fusion

2020 ◽  
Vol 32 (1) ◽  
pp. 31-35
Author(s):  
Mladen Djurasovic ◽  
Jeffrey L. Gum ◽  
Charles H. Crawford ◽  
Kirk Owens ◽  
Morgan Brown ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Minimally Invasive ◽  
Interbody Fusion ◽  
Smoking Status ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Direct Costs ◽  
Lumbar Interbody Fusion ◽  
Related Quality ◽  
Health Related

OBJECTIVEThe midline transforaminal lumbar interbody fusion (MIDLIF) using cortical screw fixation is a novel, minimally invasive procedure that may offer enhanced recovery over traditional open transforaminal lumbar interbody fusion (TLIF). Little information is available regarding the comparative cost-effectiveness of the MIDLIF over conventional TLIF. The purpose of this study was to compare cost-effectiveness of minimally invasive MIDLIF with open TLIF.METHODSFrom a prospective, multisurgeon, surgical database, a consecutive series of patients undergoing 1- or 2-level MIDLIF for degenerative lumbar conditions was identified and propensity matched to patients undergoing TLIF based on age, sex, smoking status, BMI, diagnosis, American Society of Anesthesiologists Physical Status Classification System (ASA) class, and levels fused. Direct costs at 1 year were collected, including costs associated with the index surgical visit as well as costs associated with readmission. Improvement in health-related quality of life was measured using EQ-5D and SF-6D.RESULTSOf 214 and 181 patients undergoing MIDLIF and TLIF, respectively, 33 cases in each cohort were successfully propensity matched. Consistent with propensity matching, there was no difference in age, sex, BMI, diagnosis, ASA class, smoking status, or levels fused. Spondylolisthesis was the most common indication for surgery in both cohorts. Variable direct costs at 1 year were $2493 lower in the MIDLIF group than in the open TLIF group (mean $15,867 vs $17,612, p = 0.073). There was no difference in implant (p = 0.193) or biologics (p = 0.145) cost, but blood utilization (p = 0.015), operating room supplies (p < 0.001), hospital room and board (p < 0.001), pharmacy (p = 0.010), laboratory (p = 0.004), and physical therapy (p = 0.009) costs were all significantly lower in the MIDLIF group. Additionally, the mean length of stay was decreased for MIDLIF as well (3.21 vs 4.02 days, p = 0.05). The EQ-5D gain at 1 year was 0.156 for MIDLIF and 0.141 for open TLIF (p = 0.821). The SF-6D gain at 1 year was 0.071 for MIDLIF and 0.057 for open TLIF (p = 0.551).CONCLUSIONSCompared with patients undergoing traditional open TLIF, those undergoing MIDLIF have similar 1-year gains in health-related quality of life, with total direct costs that are $2493 lower. Although the findings were not statistically significant, minimally invasive MIDLIF showed improved cost-effectiveness at 1 year compared with open TLIF.

Incidence of graft extrusion following minimally invasive transforaminal lumbar interbody fusion

2016 ◽  
Vol 24 ◽  
pp. 88-93 ◽  
Author(s):  
Joshua Bakhsheshian ◽  
Ryan Khanna ◽  
Winward Choy ◽  
Cort D. Lawton ◽  
Alex T. Nixon ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Graft Extrusion
Sign in / Sign up

Export Citation Format

Share Document