Objective:

We aim to compare peri/postoperative clinical outcomes between minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and anterior lumbar interbody fusion (ALIF) in patients presenting for revision surgery.

Methods:

A retrospective database was reviewed for procedures between November 2005 and December 2021. Revision MIS-TLIF/ALIFs were included, while primary fusions or diagnosis of infection/malignancy/trauma were excluded. Patients were grouped into MIS-TLIF/ALIF cohorts. Pre/postoperatively collected PROMs included Visual Analogue Scale (VAS) back/leg, Oswestry Disability Index (ODI), Patient-Reported Outcome Measurement Information System-Physical Function (PROMIS-PF), and Short Form-12 Item Survey Mental/Physical Composite Scores (SF-12 MCS/PCS).

Results:

164 patients were eligible, with 84 patients in the MIS-TLIF cohort. The presence of degenerative spondylolisthesis and central stenosis, narcotic consumption on POD 0/1, and postoperative urinary retention rates were greater in the MIS-TLIF cohort (p≤0.036, all). Preoperative PROMs between cohorts did not significantly differ. Significantly favorable postoperative PROM scores were demonstrated in the MIS-TLIF cohort with PROMIS-PF at 12-weeks/6-months (p≤0.033, all). Most patients in both cohorts achieved overall MCID for VAS back/leg, ODI, SF-12 PCS, and PROMIS-PF. No differences were noted between cohorts within rates of MCID achievement.

Conclusion:

Patients undergoing revision fusion via MIS-TLIF or ALIF reported similar 1-year postoperative mean outcomes and rates of meaningful clinical achievement for physical function, mental health, disability, and back/leg pain. However, patients undergoing revision MIS-TLIF reported improved physical function at the 12 weeks and 6 months. Perioperatively, patients undergoing revision MIS-TLIF were noted to consume significantly greater quantities of narcotics.