PT  - JOURNAL ARTICLE
AU  - Singhatanadgige, Weerasak
AU  - Chamadol, Hathaiphoom
AU  - Tanasansomboon, Teerachat
AU  - Kang, Daniel G.
AU  - Yingsakmongkol, Wicharn
AU  - Limthongkul, Worawat
TI  - Surgical Outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion Using Surgical Microscope vs Surgical Loupes: A Comparative Study
AID  - 10.14444/8303
DP  - 2022 May 16
TA  - International Journal of Spine Surgery
PG  - 8303
4099  - https://www.ijssurgery.com/content/early/2022/07/13/8303.short
4100  - https://www.ijssurgery.com/content/early/2022/07/13/8303.full
AB  - Background Minimally invasive transforaminal interbody fusion (MIS-TLIF) is an effective procedure for lumbar spine diseases. The procedure can be done using a surgical microscope (SM) or surgical loupes (SL) magnification. However, there are no studies that compared outcomes between using these 2 magnifying devices in the MIS-TLIF procedure. The purpose of this study was to compare clinical outcomes, perioperative complications, and radiographic parameters of MIS-TLIF using SM compared with SL magnification.Methods We included all patients undergoing 1-level MIS-TLIF between January 2017 and December 2019. Type of magnification (SM vs SL), operative time, blood loss, perioperative complications, cross-sectional area of the spinal canal, and fusion rates were analyzed. Clinical outcomes measurement using the visual analog scale (VAS) and Oswestry Disability Index (ODI) were compared between groups.Results A total of 100 patients had underwent MIS-TLIF (SM group: 62; SL group: 38). Operative time (SM: 182.7 ± 41.5 vs SL: 165.6 ± 32.6 minutes, P = 0.043) was significantly shorter in the SL group, with a mean difference of 17.2 minutes and a 10.4% increase in operative time between SL and SM. Blood loss (SM: 187.4 ± 176.4 vs SL: 215.6 ± 99.4 mL, P = 0.36) was not different between groups, with a mean difference of 28.2 mL. Both the SM group and SL group demonstrated no significant differences in improvement from baseline in VAS back, VAS legs, ODI score, and cross-sectional area of the spinal canal. There was also no significant difference in complication rates and fusion rates between groups.Conclusions Our study found no difference between intraoperative use of SL compared with SM in clinical outcomes through the 12-month follow-up timepoint. However, the use of SM resulted in an increased average operative time of 17 minutes compared with the SL group.Clinical Relevance Intraoperative use of SM and SL magnification in MIS-TLIF provides similar outcomes except prolonged operative time in the SM group.Level of Evidence 3.