Is multilevel MIS-TLIF with bilateral facetectomy a lordosing procedure?

J Neurosurg Spine 42:158–168, 2025

• Objective: The study aimed to evaluate the outcomes of 3-level minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and its effect on sagittal balance, particularly in patients with different preoperative segmental lordosis (SL) values.

• Methods: A retrospective analysis of 47 patients who underwent 3-level MIS-TLIF was conducted, with a focus on radiological and clinical outcomes.

• Surgical Techniques: The procedure involved using bullet-shaped static polyetheretherketone cages filled with autologous bone graft and demineralized bone matrix (DBM).

• Results: Patients with a preoperative SL ≤ 27° showed significant improvements in spinopelvic parameters, while those with SL > 27° had insignificant changes.

• Clinical Outcomes: All patients reported clinical improvements, as evidenced by the Oswestry Disability Index and visual analog scale scores.

• Conclusions: The study concluded that 3-level MIS-TLIF can effectively improve sagittal balance, especially in patients with a smaller preoperative lordotic curve.

• Implications: The findings suggest that MIS-TLIF is beneficial for restoring lumbar alignment and improving clinical outcomes in specific patient groups.

• Limitations: The study’s limitations include a small sample size and lack of a control group, which may affect the generalizability of the results.