Research Mentor Name

Victor Chang

Research Mentor Email Address

Institution / Department

Henry Ford Hospital / Neurosurgery

Document Type

Research Abstract

Research Type


Level of Research



Minimally invasive (MIS) lumbar fusion surgery continues to gain popularity with promising clinical results, such as better functional mobility, and decreased hospital stay. As being opioid-naive has been described as a protective risk factor for postoperative opioid consumption, the objective of this study is to determine the differences in long-term opioid usage between Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS TLIF) versus traditional open lumbar interbody fusions. We hypothesize that patients undergoing MIS surgery will have a greater degree of pain control compared to open surgical cases.

All lumbar fusion surgeries performed between 2019 and 2021 were reviewed independently for opioid morphine milliequivalent (MME) requirements from 6 months pre-operatively to 1 year post-operatively. The Michigan Spine Surgery Improvement Collaborative (MSSIC) was utilized for all patient outcomes.

Of the 292 patients included, 71 patients had MIS-TLIF while 221 patients underwent open lumbar interbody fusions. 66 (23%) had at least one opioid prescription 6-12 months post-surgery. There were no differences in opioid prescription rates between the two groups. Among patients with an opioid prescription, MIS-TLIF patients had lower daily MMEs when compared to open cases at 6-12 months post-surgery (p=0.048). Patients with opioid prescriptions also had higher rates of DVT, history of depression, history of anxiety, COPD, PHQ2 depression at baseline, reported pre-op daily use of opioids, longer duration of symptoms and lower baseline PROMIS physical function scores. No statistically significant differences were observed for patient satisfaction at 1 & 2 years or MCID PROMIS at 90 days and 1 year after surgery. Length-of-surgery, estimated blood loss, and length-of-hospital stay were significantly lower for MIS TLIF compared to open surgery.

Although there were no differences in opioid prescription rates, the daily opioid consumption of 6-12 months after surgery was lower for MIS-TLIF cases. There were no differences in long-term functional outcomes between open and MIS-TLIF surgeries.


Medicine and Health Sciences