Abstract:
Objective: This study aims to evaluate the short- and long-term outcomes—specifically in terms of pain, disability, and
quality of life—between minimally invasive surgery (MIS) and open transforaminal lumbar interbody fusion (TLIF) for
treating lumbar spondylolisthesis.
Study Design and Setting: A prospective cohort study was carried out at Liaquat National Hospital & Medical College,
Karachi, and a teaching institution in South Asia. The study included patients with chronic back pain for over three months,
unresponsive to medical treatment or accompanied by radicular symptoms, with MRI-confirmed grade I and II degenerative
lumbar spondylolisthesis, lateral recess stenosis, and unilateral disc herniation. Patients with spinal metastasis, previous
surgeries, inflammatory arthritis, or metabolic bone diseases were excluded.
Methodology: The outcomes of MIS-TLIF and open-TLIF were assessed using the Visual Analog Scale (VAS), Oswestry
Disability Index (ODI), and SF-36 quality of life scores at 1, 6, and 24 months postoperatively.
Results: Among 93 patients, 35 underwent open-TLIF and 58 received MIS-TLIF. MIS-TLIF resulted in significantly less
blood loss and faster recovery. At four weeks, the MIS group had lower VAS and ODI scores, and higher SF-36 scores.
Similar trends continued at six months, with improvements in ODI and SF-36. By 24 months, the MIS group maintained
lower ODI scores, though VAS and SF-36 scores were comparable.
Conclusion: MIS-TLIF shows superior outcomes, especially in the early postoperative phase, with reduced morbidity and
improved quality of life, making it a preferable option in resource-limited settings
