A prospective, multi-institutional comparative effectiveness study of lumbar spine surgery in morbidly XXXX @entity1 : does minimally invasive transforaminal lumbar interbody fusion result in superior outcomes?

@entity1 @entity1643 @entity248 @entity28 @entity260 @entity615 @entity179 @entity158 @entity717 @entity614
BACKGROUND: Obese and morbidly @entity28 @entity1 undergoing lumbar spinal fusion surgery are a challenge to the operating surgeon. Minimally invasive transforaminal lumbar interbody fusion ( @entity248 ) and open-TLIF have been performed for many years with good results; however, functional outcomes after lumbar spine surgery in this subgroup of @entity1 remain poorly understood. Furthermore, whether index @entity248 or open-TLIF for the treatment of @entity179 or spondylolisthesis in morbidly @entity28 results in superior postoperative functional outcomes remains unknown. METHODS: A total of 148 ( @entity248 : n  = 40, open-TLIF: n  = 108) @entity28 and morbidly @entity28 @entity1 undergoing index lumbar arthrodesis for @entity1643 and/or @entity614 between January 2003 and December 2010 were selected from a multi-institutional prospective data registry. We collected and analyzed data on @entity1 demographics, @entity260 , @entity615 , @entity158 , and functional disability over 2 years. @entity1 completed the @entity717 Index (ODI), Medical Outcomes Study Short-Form 36 (SF-36), and back and @entity158 numerical rating scores before surgery and then at 12 and 24 months after surgery. Clinical outcomes and complication rates were compared between both @entity1 cohorts. RESULTS: Compared with preoperative status, Visual Analog Scale (VAS) back and @entity158 , ODI, and SF-36 physical component score/mental component score were improved in both groups. Both @entity248 and open-TLIF @entity1 showed similar 2-year improvement in VAS for @entity615 ( @entity248 : 2.42    3.81 vs. open-TLIF: 2.33    3.67, P  = 0.89), VAS for @entity158 ( @entity248 : 3.77    4.53 vs. open-TLIF: 2.67    4.10, P  = 0.18), ODI ( @entity248 : 11.61    25.52 vs. open-TLIF: 14.88    22.07, P  = 0.47), and SF-36 physical component score ( @entity248 : 8.61    17.72 vs. open-TLIF: 7.61    15.55, P  = 0.93), and SF-36 mental component score ( @entity248 : 4.35    22.71 vs. open-TLIF: 5.96    21.09, P  = 0.69). @entity260 rates between both cohorts were also not significantly divergent between (12.50% vs. 11.11%, P  = 0.51). CONCLUSION: @entity248 is a safe and viable option for lumbar fusion in morbidly @entity28 @entity1 and, compared with open-TLIF, resulted in similar improvement in @entity158 . @entity260 rates between both cohorts were also not significantly divergent.
