Spine

FAQs for MIS Lumbar Spine Patients — Print This One Out!

Ten common questions for lumbar spine patients — answered

What’s the Claim?

There were lots of claims here, and we believe you’ll find most or all of them practical, as in “you can use this in your practice.” The authors used a large institutional database to answer 10 “FAQs” that matter to patients thinking about MIS transforaminal lumbar interbody fusion (MI-TLIF), MIS decompression (unilateral laminectomy for bilateral decompression), or tubular microdiscectomy. The questions were intentionally basic, which we think may make the answers useful for creating educational materials for your patients. A summary of the FAQs and their answers is provided below.

How’s It Stack Up?

CORRelations’ advisor in Spine characterized this one as having a “fascinating study design” and felt the estimates the authors made were realistic when held against his experience and the best-available evidence on those questions, which are front of mind for many patients. Note that these findings apply only to patients having one-level TLIF, but multilevel decompressions and tubular microdiscectomies were included here.

What’s Our Take?

Two things to factor in:

The flip side of each of the answers are telling — if 80% return to work, that means 20% don’t, and if 60% of patients achieve a clinically important improvement by six months, that means 40% don't.
While all patients in this report had at least 1 year of follow-up, the authors don't indicate how many were lost to follow-up before that time point. This is really important; the missing usually are doing worse (sometimes much worse) than the accounted for. We suggest presenting these findings to patients as optimistic or best-case results. Things may not be quite so rosy. Still, the table below should make a helpful conversation-starter for patients thinking about having these MIS spine procedures.