Research Mentor Name
Research Mentor Email Address
Institution / Department
Henry Ford Hospital / Neurosurgery
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
Yun, Ho Jun; Hamilton, Travis; Telemi, Edvin; Lim, Seokchun; Macki, Mohamed; Yeh, Hsueh-Han; Springer, Kylie; Schultz, Lonni; Nerenz, David; Abdulhak, Muwaffak; Taliaferro, Kevin; Schwalb, Jason; Khalil, Jad; Aleem, Ilyas; Easton, Richard; Perez-Cruet, Mick; Park, Paul; and Chang, Victor, "Opioid Usage and Clinical Outcomes After Minimally Invasive Surgery (MIS) Versus Open Lumbar Fusions" (2022). Medical Student Research Symposium. 181.