2015 ISAKOS Biennial Congress ePoster #2501
Clinical Results of MIS-TLIF for Athletes
Yudo Hachiya, MD, PhD, Nagoya, Aichi JAPAN
Koichi Muramatsu, MD, Nagoya JAPAN
Kenichiro Tanaka, MD, Nagoya JAPAN
Hiroki Watanabe, MD, Nagoya JAPAN
Shoichi Taniguchi, MD, Nagoya JAPAN
Atsushi Yoshioka, MD, Nagoya JAPAN
Hachiya Orthopaedic Hospital, Nagoya , JAPAN
FDA Status Not Applicable
Summary: We performed MIS-TLIF for 15 Athletes. They were able to return to their sport on previous competition level after surgery because the change of signal intensity in MIS-TLIF was significantly lower than conventional TLIF and MIS-TLIF cases showed significant improvement with JOABPEQ effective rate in each factor.
The purpose of this study is to report that our MIS-TLIF procedures giving negligible effect on back muscle accomplish good clinical result for athletes.
The study examined 15 athletes who underwent MIS-TLIF for their lumbar disc herniation more than 1 year ago. There were 10 males and 5 females. The mean age was 22.3 years (15-45 years). The breakdown of their sporting histories were 4 baseball players, 2 basketball players, 1 table tennis player, 1 soft ball player, 1 volleyball player, 1 cyclist, 1 ballet dancer, 1badminton player, 1 karate player, 1 fire fighter and 1 self-defense forces personnel. Six of them were top-level athletes. 3 patients underwent two-level T&LIF and the rest of them did one-level TLIF. The JOA score and JOABPEQ score were used to assess the clinical result of MIS-TLIF and MRI evaluate the change in signal intensity and muscle cross-sectional area before and after the procedures. Dynamic CT also determine the bone fusion.
The procedures improved average JOA score of those patients by 94.2% from 16.7 points at preoperative measurement to 28.1 points at the postoperative measurement. JOABPEQ score was also used to examine the efficacy of the procedures, showing 86.7% improvement in lower back pain, 66.7% improvement in lumbar function, walking and mental health and 60.0 % improvement in social life function. The average time for bone fusion was 14.2 weeks. All of the athletes were able to return to their competitive careers in sport. If the patient satisfaction in their sports before having symptoms and pains is 100%, the mean satisfaction rate after the surgeries was 88.6%.
The most of athletes who developed disc herniation or spondylolysis were usually treated by the surgical treatments such as herniotomy and decompression and these cases were often not indication for spinal fusion. The invasive lumbar spinal fusion for athletes tended to be avoided due to its negative effect on back muscle. However, even after the surgical treatment, some of them still suffered from residual back pains and recurrent disease, so all of them were not able to return to their sports activities. MIS-TLIF is well recognized to have little negative effects on back muscle from the results of MRI and electrophysiologic test. The previous study in our institution compared the changes in signal intensity in MIS-TLIF and conventional TLIF. The study showed that the change in MIS-TLIF was significantly lower than conventional TLIF. In this study, the postoperative result of MIS-TLIF for 15 athletes showed significant improvement with stable JOAPBEQ effective rates in each factor. In addition all of athletes were able to return to their sports on previous competition level. So MIS-TLIF is one of very effective treatment for athletes.