{"id":"dce4eecc-0126-4bf7-bf4d-f164337b4839","slug":"extent-of-intraoperative-muscle-dissection-does-not-affect-long-term-outcomes-after-minimally-invasive-surgery-versus-open-transforaminal-lumbar-interbody-fusion-surgery-a-prospective-longitudinal-co","title":"Extent of intraoperative muscle dissection does not affect long-term outcomes after minimally invasive surgery versus open-transforaminal lumbar interbody fusion surgery: A prospective longitudinal cohort study","authors":["Owoicho Adogwa","Kwame Johnson","Elliot T. Min","Neil Issar","Kevin R. Carr","Kevin Huang","Joseph Cheng"],"abstract":"Background: Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) versus open TLIF, addressing lumbar degenerative disc disease (DDD) or grade I spondylolisthesis (DS), are associated with shorter hospital stays, decreased blood loss, quicker return to work, and equivalent short- and long-term outcomes. However, no prospective study has assessed whether the extent of intraoperative muscle trauma utilizing creatinine phosphokinase levels (CPK) differently impacts long-term outcomes. Methods: Twenty-one patients underwent MIS-TLIF (n = 14) versus open-TLIF (n = 7) for DDD or DS. Serum CPK levels were measured at baseline, and postoperatively (days 1, 7, and 1.5, 3 and 6 months). The correlation between the extent of intraoperative muscle trauma and two-year improvement in functional disability was evaluated (multivariate regression analysis). Additionally, baseline and two-year changes in Visual Analog Scale (VAS)-leg pain (LP), VAS-back pain (BP), Oswestry Disability Index (ODI), Short-Form-36 (SF-36) Physical Component Score (PCS) and SF-36 Mental Component Score (MCS), and postoperative satisfaction with surgical care were assessed. Results: Although the mean change from baseline in the serum creatine phosphokinase level on POD 1 was greater for MIS-TLIF (628.07) versus open-TLF (291.42), this did not correlate with lesser two-year improvement in functional disability. Both cohorts also showed similar two-year improvement in VAS-LP, ODI, and SF-36 PCS/MCS. Conclusion: Increased intraoperative muscle trauma unexpectedly observed in higher postoperative CPK levels for MIS-TLIF versus open-TLIF did not correlate with any differences in two-year improvement in pain and functional disability.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/dce4eecc-0126-4bf7-bf4d-f164337b4839/featured/hero-1782420872725.png","publishDate":"2012-11-26T00:00:00.000Z","doi":"10.4103/2152-7806.103868","categories":["Original Article"],"fullTextUrl":"http://sni.wpengine.com/wp-content/uploads/2015/04/3561/SNI-3-355.pdf"}