Comparative study of modified midline lumbar interbody fusion and modified transforaminal lumbar interbody fusion for the treatment of single-level lumbar degenerative diseases.

Yuanpeng Yue, Yihui Liu, Ce Dong, Zhenyu Wang

Abstract readComparative Study

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Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 citing paper in PubMed.

Robotic-assisted midline lumbar interbody fusion for the treatment of degenerative lumbar spinal stenosis: a prospective, randomized, controlled, non-inferiority clinical trial protocol.Journal of spine surgery (Hong Kong) · 2026
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4 authors.

Yuanpeng YueDepartment of Orthopedics, Spine Surgery, The First Hospital of Jilin University, Jilin University, 1 Xinmin Street, Changchun, 130000, China.

Yihui LiuDepartment of Orthopedics, Spine Surgery, The First Hospital of Jilin University, Jilin University, 1 Xinmin Street, Changchun, 130000, China.

Ce DongDepartment of Orthopedics, Spine Surgery, The First Hospital of Jilin University, Jilin University, 1 Xinmin Street, Changchun, 130000, China.

Zhenyu WangDepartment of Orthopedics, Spine Surgery, The First Hospital of Jilin University, Jilin University, 1 Xinmin Street, Changchun, 130000, China. zhenyu@jlu.edu.cn.ORCID http://orcid.org/0000-0003-2688-162X

Funding

The Jilin Provincial science and technology development program No.20230401089YY

6 · The paper itself

Abstract

purposeTo evaluate the safety and efficacy of modified cortical bone trajectory (MCBT) screw combined with transarticular screw (TASS) fixation (MCBT-TASS) in modified midline lumbar interbody fusion (M-MIDLIF) for single-level lumbar degenerative disease (LDD).

methodsWe retrospectively included 104 patients with L4-5 or L5-S1 single-segment LDD who had indications for decompression, fusion, and internal fixation surgery from 2019 to 2022. They were subsequently divided into M-MIDLIF and modified transforaminal lumbar interbody fusion (M-TLIF) groups according to the surgical approach. Basic demographic, surgical, and radiological data, as well as clinical outcomes (Oswestry Disability Index (ODI) and visual analog scale (VAS) scores), were collected.

resultsBasic demographic data, fusion rates, postoperative hospital stays, and follow-up times did not significantly differ between the two groups. Compared with those in the M-TLIF group, the intraoperative blood loss (68.57 ± 14.84 mL) and postoperative drainage volume (33.93 ± 9.17 mL) in the M-MIDLIF group were lower (intraoperative blood loss: 171.79 ± 12.78 mL, p < 0.05; postoperative drainage volume: 65.36 ± 10.36, p < 0.05). In the M-MIDLIF group, there was no significant difference in the radiographic recognizable rate (91.07%) or intraoperative visual recognizable rate (87.50%) of internal inverted chevron-shaped (V-shaped) crests. The optimal position screw rates for the MCBT, TASS, and traditional pedicle screw (TPS) methods were 94.64%, 94.64%, and 87.5%, respectively, and the differences were not significant. MCBT technology preserved the integrity of the posterior ligamentous complex (PLC) in 92.85% of patients in the M-MIDLIF group. The facet joint violation (FJV) rate of MCBT screws (3.57%) was lower than that of TPS screws (14.29%). Compared with the M-TLIF group, the M-MIDLIF group presented greater reductions in the ODI and VAS scores for both low back and leg pain at 1 week postoperatively (P < 0.05). However, no statistically significant differences in these scores were observed between the two groups at later time points (p > 0.05).

conclusionM-MIDLIF can achieve decompression, fixation, and fusion via a median incision while preserving the integrity of the posterior ligamentous complex. In the treatment of single-level lumbar degenerative disease, M-MIDLIF has comparatively enhanced minimally invasive advantages over M-TLIF during the perioperative period while maintaining non-inferior clinical safety and efficacy relative to M-TLIF.

Indexed as

Intervertebral Disc DegenerationLumbar VertebraeSpinal FusionAdultAgedBone ScrewsFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeCortical bone trajectory screwMidline lumbar interbody fusionPedicle screwTransarticular surface screwTransforaminal lumbar interbody fusion

Identifiers

PMID40846925

DOI10.1186/s12893-025-03100-7

PMCPMC12372285

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