Structured Titanium TLIF Cage with and without Adjacent Level Dynamic Stabilization - A Retrospective 1-Year Follow-Up Study

Abstract Background: Minimally invasive transforaminal lumbar interbody fusion (TLIF) was developed to achieve interbody fusion without anterior access. Dynamic stabilization systems (DSS) were introduced to mitigate adjacent segment disease by providing less rigid fixation of the spinal segment. The objective of this study was to analyze if there is a different clinical and radiographic outcome with dynamic stabilization adjacent to fusion compared to TLIF alone. Methods: We conducted a retrospective cohort study and analyzed all patients who underwent minimally invasive TLIF between 2019 and 2021. Demographic, perioperative, and patient-reported outcomes, including disability (Oswestry Disability Index, ODI), pain (Visual Analog Scale for back and leg pain), and health-related quality of life (HrQoL), were collected. The primary outcome was the ODI at the 12-month follow-up. Interbody fusion rates were assessed by CT scans 12 months postoperatively. Results: We included 82 participants, divided into hybrid (n=41) and non-hybrid (n=42) techniques. The demographic analysis revealed a mean age of 62.1 years, with a majority of female participants (57%). Both groups showed significant improvement in the ODI and HrQoL scores at various time points (p>0.05). No significant differences were found between the hybrid and non-hybrid groups regarding surgical and clinical outcomes. Non-union was not statistically higher in the non-hybrid group (11.4%) compared to the hybrid cohort (2.7%; p=0.716). Conclusion: Our study demonstrates significant improvement in patient-reported outcomes one year after minimally invasive TLIF procedures, regardless of the inclusion of DSS.