European Spine Journal

, Volume 28, Issue 9, pp 2095–2102 | Cite as

Differences in the interbody bone graft area and fusion rate between minimally invasive and traditional open transforaminal lumbar interbody fusion: a retrospective short-term image analysis

  • Yu-Cheng Yao
  • Hsi-Hsien Lin
  • Po-Hsin Chou
  • Shih-Tien Wang
  • Ming-Chau ChangEmail author
Original Article



We aimed to quantify the interbody bone graft area following transforaminal lumbar interbody fusion (TLIF) using traditional open and minimally invasive surgeries (MIS) and investigate their correlations with rates of fusion, complications, and clinical outcomes.


Patients undergoing TLIF of 1 or 2 levels between October 2015 and December 2016 were retrospectively included. Fusion and bone graft areas were assessed with computed tomography (CT) at 6 months postoperatively. The bone graft area ratio was defined as the bone graft area divided by the average endplate area. The distributions of bone graft area within the discs were also recorded. Clinical outcomes were assessed using the visual analog scale (VAS) and Oswestry Disability Index (ODI) questionnaires.


In total, 77 disc levels in 57 patients were analyzed. The fusion rate was 79.1% in the open group and 82.4% in the MIS group (p = 0.718). Clinical outcomes of both groups improved significantly. Changes in VAS and ODI scores at 12 months postoperatively were comparable between groups. Bone graft area ratio was not significantly different between the two groups (open, 38 ± 10.8%; MIS, 38.1 ± 9.0%, p = 0.977). Analysis of bone graft distribution revealed that the contralateral-dorsal part of the disc had the lowest bone graft area. The bone graft area ratio was significantly higher in the solid union group (39.2 ± 10.4%) than in the non-solid union group (33.5 ± 6.4%, p = 0.048).


The fusion rates, bone graft area ratios, clinical outcomes, and complications were similar between MIS and open TLIF.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.


TLIF MIS Bone graft area Endplate preparation Fusion rate Clinical outcome 



We thank Hsin-Yi Huang from the Biostatistics Task Force, Taipei Veterans General Hospital, for the statistical assistance.

Compliance with ethical standards

Conflict of interest

None of the authors have any potential conflict of interests.

Supplementary material

586_2019_6002_MOESM1_ESM.pptx (324 kb)
Supplementary material 1 (PPTX 324 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopedics and TraumatologyTaipei Veterans General HospitalTaipeiTaiwan, ROC
  2. 2.Department of Surgery, School of MedicineNational Yang-Ming UniversityTaipeiTaiwan, ROC

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