Table 2.
Surgery-specific information on n=71 patients with degenerative disc disease undergoing standard TLIF surgery, or TLIF with release of the anterior longitudinal ligament (ALL) between L4 and S1 (transforaminal anterior release = TFAR).
| TFAR | Standard TLIF | p-value | |
|---|---|---|---|
| Surgeon board-certified in | .411 | ||
| Neurosurgery | 8 (44.4%) | 23 (43.4%) | |
| Orthopedic surgery | 10 (55.6%) | 30 (57.7%) | |
| Surgeon's level of experience | .761 | ||
| Junior attending | 3 (16.7%) | 13 (24.5%) | |
| Senior attending | 7 (38.9%) | 19 (35.8%) | |
| Leading surgeon | 8 (44.4%) | 21 (39.6%) | |
| Extent of procedure | .034 | ||
| Monosegmental fusion | 9 (50.0%) | 31 (58.5%) | |
| Bisegmental fusion | 4 (22.2%) | 19 (35.9%) | |
| Multilevel fusion | 5 (27.8%) | 3 (5.7%) | |
| Anterior-posterior approach w/ LLIF/XLIF | .159 | ||
| No | 14 (77.8%) | 48 (90.6%) | |
| Yes | 4 (22.2%) | 5 (9.4%) | |
| Posterior approach | .758 | ||
| Midline, conventional open | 17 (94.4%) | 50 (96.2%) | |
| Transmuscular, “Wiltse” | 1 (5.6%) | 2 (3.8%) | |
| Pedicle screw placement | .047 | ||
| Free-hand technique | 16 (88.9%) | 34 (64.2%) | |
| Intraoperative 3D imaging and navigation | 2 (11.1%) | 19 (35.8%) | |
| Cement-augmentation of pedicle screws | .229 | ||
| No | 13 (72.2%) | 45 (84.9%) | |
| Yes | 5 (27.8%) | 8 (15.1%) | |
| Use of intraoperative neuromonitoring | .435 | ||
| No | 16 (88.9%) | 50 (94.3%) | |
| Yes | 2 (11.1%) | 3 (5.7%) | |
| Length of surgery, in min | 442 (163) | 319 (142) | .001 |
| Estimated blood loss, in ml | 1385 (969) | 581 (638) | .025 |
| Intraoperative use of blood products | .001 | ||
| None | 13 (72.2%) | 52 (98.1%) | |
| Cellsaver and retransfusion | 4 (22.2%) | −(0.0%) | |
| Red blood cell transfusion | 1 (5.6%) | 1 (1.9%) | |
| Intraoperative surgical AEs | .789 | ||
| None | 15 (83.3%) | 47 (88.7%) | |
| Dural leak | 2 (11.1%) | 3 (5.7%) | |
| Vascular injury | −(0.0%) | 1 (1.9%) | |
| Other* | 1 (5.6%) | 2 (3.8%) | |
| Intraoperative medical AEs | .158 | ||
| None | 15 (83.3%) | 50 (94.3%) | |
| Cardiovascular decompensation | 2 (11.1%) | 3 (5.7%) | |
| Other anesthesiological | 1 (5.6%) | −(0.0%) | |
| Total | n=18 (100%) | n=53 (100%) |
⁎
Other listed AEs were pedicle screw loosening with implant replacement (n=1) and potential endplate violation (n=2). Data is presented as count (percent) or mean (standard deviation).