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Research ArticleMinimally Invasive Surgery

Surgical Outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion Using Surgical Microscope vs Surgical Loupes: A Comparative Study

Weerasak Singhatanadgige, Hathaiphoom Chamadol, Teerachat Tanasansomboon, Daniel G. Kang, Wicharn Yingsakmongkol and Worawat Limthongkul
International Journal of Spine Surgery July 2022, 8303; DOI: https://doi.org/10.14444/8303
Weerasak Singhatanadgige
1 Department of Orthopedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
2 Center of Excellence in Biomechanics and Innovative Spine Surgery, Chulalongkorn University, Bangkok, Thailand
MD, MS
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Hathaiphoom Chamadol
1 Department of Orthopedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
MD
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Teerachat Tanasansomboon
1 Department of Orthopedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
2 Center of Excellence in Biomechanics and Innovative Spine Surgery, Chulalongkorn University, Bangkok, Thailand
MD
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Daniel G. Kang
3 Department of Orthopaedic Surgery, Madigan Army Medical Center, Washington, USA
MD
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Wicharn Yingsakmongkol
1 Department of Orthopedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
2 Center of Excellence in Biomechanics and Innovative Spine Surgery, Chulalongkorn University, Bangkok, Thailand
MD
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Worawat Limthongkul
1 Department of Orthopedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
2 Center of Excellence in Biomechanics and Innovative Spine Surgery, Chulalongkorn University, Bangkok, Thailand
MD
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Figures

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    Figure 1

    Spinal canal cross-sectional area was measured by drawing the line surrounding spinal canal using digital synapse picture archiving and communication system.

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    Figure 2

    Patient-reported outcome in (A) visual analog scale (VAS) back, (B) VAS legs, and (C) Oswestry Disability Index (ODI).

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    Table 1

    Demographic data.

    Patient DemographicsSurgical Microscope(n = 62)Surgical Loupes(n = 38)P Value
    Age, y, mean ± SD63.7 ± 9.866.3 ± 9.20.23
    Body mass index, mean ± SD25.0 ± 3.725.1 ± 3.90.98
    Diabetes, n (%)12 (19.4)8 (21.1)0.38
    Hypertension, n (%)36 (58.1)18 (47.4)0.64
    Dyslipidemia, n (%)27 (43.6)12 (31.6)0.9
    Smoker, n (%)6 (9.7)1 (2.6)0.23
    Operated level, n (%)
     L2-L31 (1.6)0 (0)0.32
     L3-L47 (11.3)5 (13.2)0.55
     L4-L543 (69.4)28 (73.6)0.02
     L5-S111 (17.7)5 (13.2)0.12
    Diagnosis, n (%)
     Spondylolisthesis23 (36.9)19 (48.4)0.3
     Spinal canal stenosis21 (33.8)12 (32.3)0.88
     Herniated nucleus pulposus17 (27.7)7 (19.4)0.59
     Degenerative disc disease1 (1.5)00.64
    • View popup
    Table 2

    Patient-reported outcome in back pain (VAS back) and leg pain (VAS legs).

    TimepointVAS BackVAS Legs
    Surgical MicroscopeSurgical LoupesP ValueSurgical MicroscopeSurgical LoupesP Value
    Baseline6.8 ± 3.26.0 ± 4.20.445.9 ± 3.57.4 ± 30.052
    1 d2 ± 1.61.8 ± 1.80.7251.1 ± 2.42.25 ± 20.381
    1 mo1.5 ± 2.41.2 ± 2.30.5380.8 ± 1.51.6 ± 2.50.192
    3 mo1.4 ± 2.30.9 ± 2.30.4781 ± 2.41.6 ± 2.50.453
    6 mo1.5 ± 2.71.3 ± 2.40.7191.2 ± 2.61.8 ± 2.60.489
    12 mo0.9 ± 1.91.2 ± 2.30.7020.6 ± 1.70.9 ± 1.70.615
    • Abbreviations: VAS, visual analog scale.

    • Data provided as mean ± SD.

    • View popup
    Table 3

    Patient-reported outcome in back pain (ODI).

    ODI TimepointSurgical MicroscopeSurgical LoupesP Value
    Baseline46.5 ± 15.650.7 ± 16.40.297
    1 mo11 ± 12.912.4 ± 14.50.734
    3 mo13 ± 19.99.6 ± 13.20.437
    6 mo10.5 ± 18.712.7 ± 16.60.675
    12 mo5.5 ± 13.510.7 ± 160.249
    • Abbreviations: ODI, Oswestry Disability Index.

    • Data provided as mean ± SD.

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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Surgical Outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion Using Surgical Microscope vs Surgical Loupes: A Comparative Study
Weerasak Singhatanadgige, Hathaiphoom Chamadol, Teerachat Tanasansomboon, Daniel G. Kang, Wicharn Yingsakmongkol, Worawat Limthongkul
International Journal of Spine Surgery Jul 2022, 8303; DOI: 10.14444/8303

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Surgical Outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion Using Surgical Microscope vs Surgical Loupes: A Comparative Study
Weerasak Singhatanadgige, Hathaiphoom Chamadol, Teerachat Tanasansomboon, Daniel G. Kang, Wicharn Yingsakmongkol, Worawat Limthongkul
International Journal of Spine Surgery Jul 2022, 8303; DOI: 10.14444/8303
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More in this TOC Section

  • Comparative Review of Lateral and Oblique Lumbar Interbody Fusion: Technique, Outcomes, and Complications
  • Key Considerations in Surgical Decision-Making on the Side of Approach for Lumbar Lateral Transpsoas Interbody Fusion Techniques
  • A Spine Surgeon’s Learning Curve With the Minimally Invasive L5 to S1 Lateral ALIF Surgical Approach: Perioperative Outcomes and Technical Considerations
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Keywords

  • minimally invasive
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  • MIS-TLIF
  • microscope
  • loupes

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