In addition, there was no significant difference between open and MI-TLIF in terms of fusion rates, etc both which were approximately 80%. Peng and colleagues presented data that was supportive of MI-TLIF in terms of pain, hospitalization, and recovery, while at the same time retaining the high-fusion rate associated with open TLIF at two year follow-up. Aside from particular pathologies that would benefit from MI-TLIF, there are certain populations that could benefit from the decreased tissue disruption and decreased blood loss. In elderly patients, Lee et al. completed a retrospective review of 27 consecutive cases and found a low complication rate and beneficial outcomes for patients over the age of 65 [12]. The average age of patients in the study was approximately 70 years, and each underwent a mini-open TLIF.

They were then followed up for three years, displaying fusion rates of nearly 80%, similar to that seen in other studies. However, 44% of patients displayed adjacent segment degeneration, which was statistically significant in terms of its relation to sacral tilt following the procedure (P = 0.006). Two patients experienced minor complications in the perioperative period, one being a drug eruption and the other a urinary tract infection. Overall, the authors strongly felt that mini-open TLIF is a low-risk, beneficial option for the elderly. 6. Conclusion Though the studies presented displayed heterogeneous patient populations with different indications for lumbar arthrodesis, there were many patterns seen across studies.

Aside from possible complications such as screw displacement and neurological deficit, which were often related to a steep learning curve, MI-TLIF displayed no significant disadvantages when compared to open TLIF or other standard lumbar fusion techniques. The risks of blood loss, narcotic administration, pseudorthrosis, and infection all are equivalent if not decreased when Entinostat utilizing MI-TLIF as a possible technique. Various postoperative recovery and pain rating scales often showed consistent improvement across many of the studies presented herein. MI-TLIF and open TLIF are quite similar in absolute indications and often present with similar complications, thus a randomized clinical trial would be beneficial in further elucidating the risks and benefits associated with each. As other variations emerge for MI-TLIF, such as METLIF, there is still need for an overall meta-analysis of all available data, comparing minimally invasive technique to traditional, open procedures. Conflict of Interests There is no conflict of interests or funding source for this paper or the data contained within it.