Authors : Suyash Singh, Jayesh Sardhara, Kamlesh Singh Bhaisora, Arun Kumar Srivastava, Sanjay Behari
DOI : 10.18231/j.ijn.2019.010
Volume : 5
Issue : 2
Year : 2019
Page No : 81-86
Introduction: The increasing demand of MISS TLIF is constraining young spine surgeons to acquire perilous technique. The apprehension for radiation exposure is usually suppressed by surgical satisfaction. The aim of this study was to share our experience of initial cases, occupational hazards faced and patient reported outcome measures (PROM). We intend to highlight the problems encountered in the learning curve and technical pearls we learnt.
Materials and Methods: The study includes initial 30 patients of spondylolisthesis operated by MISS-TLIF. The oswestry disability index (ODI) score and Patient satisfaction score at discharge and 6-months follow up were studied. Postoperative Bridwell’s anterior fusion grading used to access fusion rate at 6th month. The occupational risks and job stress was calculated using Staff stress questionnaire and compared to staff members of other sub-speciality. We also noted the number of CARM shots taken in those initial cases.
Results: There was the improvement in the mean ODI score of 61.87 ± 16.65 pre operatively to 24.23 ± 13.85 in postoperative period; (p< 0 style="background-color:white">Although the median patient’s satisfaction score was 3 at discharge, but it improved to 2 at 6th month of follow up. According to Bridwell’s fusion grading 62% of the patients in our study showed Grade 2 fusion, 31% showed grade 3 fusion. There was significant difference in median stress level of our staff compared other operating room staff members (p>0.01). Although the radiation exposure was higher compared to other series, but there was decreasing trend after 10th case.
Conclusion: MISS-TLIF is a safe and efficient technique. After optimal experience and discerning learning curve, the risk of radiation and post operative complications declines. We should advise our operating room staff workers regarding all precautionary steps and assure them regarding the safety of MIS TLIF procedure.
Keywords: Minimally invasive spine surgery, TLIF, Computer assisted radio monitoring, Oswestrry disability index, Patients satisfaction score.