Minimally Invasive Transforaminal Lumbar Interbody Fusion in the Outpatient Setting

摘要

Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has been shown to have long-term clinical outcomes similar to those with open TLIF and decreased perioperative morbidity. This study assessed whether this procedure can be safely performed in outpatient settings. Ninety-six consecutive patients undergoing 1- or 2-level MIS-TLIFs were retrospectively reviewed. They were divided into inpatient and outpatient cohorts (36%). All had a minimum of 2 years of follow-up. Patient demo-graphics, comorbidities, complications, and readmissions were examined. Early postoperative complications were stratified into wound related, infection, neurologic, implant related, and vascular injuries. Patients in the outpatient cohort were significantly younger, had lower American Society of Anesthesiologists physical status scores, and had lower Charlson Comorbidity Index scores than patients in the inpatient cohort. There were no statistically significant differences in overall postoperative complication rates, readmission rates, or final Oswestry Disability Index or visual analog scale scores between the 2 cohorts. The clinical outcomes of the outpatient TLIF procedure were similar to those of the inpatient procedure and it had an acceptable complication rate.