Enhancing precision and safety in lumbar fusion: A comparative study of navigation-assisted versus standard MIS-TLIF for single level fusion.

Introduction: Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is commonly used to treat lumbar spine pathologies such as degenerative disc disease and spondylolisthesis. Despite its advantages, standard MIS-TLIF has limitations, including restricted visualization, radiation exposure, and technical challenges. Navigation-assisted modified MIS-TLIF has been developed to enhance precision and safety. This study compares the clinical and radiological outcomes of navigation-assisted modified MIS-TLIF versus standard MIS-TLIF.

Materials and methods: This retrospective study included 66 patients who underwent lumbar fusion surgery between April 2020 and March 2023. Patients were divided into two groups: 30 underwent navigation-assisted modified MIS-TLIF and 36 underwent standard MIS-TLIF. Inclusion criteria included chronic low back pain due to lumbar degenerative conditions unresponsive to conservative management and single level pathology. Parameters evaluated included operative time, blood loss, hospital stay, complication rate, screw placement accuracy, fusion status (Bridwell grading), and functional outcomes assessed using the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS).

Results: The navigation-assisted group demonstrated lower blood loss, shorter hospital stays, and fewer complications. Pedicle screw placement accuracy was higher (96.7% vs. 88.9%). Fusion rates were comparable (Grade 1 fusion: 93.3% vs. 88.9%). Both groups showed significant improvement in ODI and VAS scores over 1 year. Final ODI and VAS scores were slightly better in the standard MIS-TLIF group but not statistically significant.

Conclusion: Navigation-assisted modified MIS-TLIF offers improved accuracy, reduced complications, and enhanced perioperative outcomes as compared to standard MIS-TLIF, while achieving similar long-term clinical and radiological results.