Midline Lumbar Fusion with cortical bone trajectory as first line treatment in a selected series of patients with lumbar instability.

OBJECT: Aim of the present study was to proof that for certain complex spinal conditions, MIDLIF technique is very convenient in terms of length of hospitalization, functional recovery and pain relief and time to back to work.

METHODS: MIDLF indications were set for patients with not more than 3 unstable levels, presence of osteoporosis (alternative to cemented screws), or cardiomyopathy with anticoagulation with or without spinal stenosis, and or discopathy. Surgical difficulties, operative time, hemoglobin loss and postoperative 45 days, 6 months and one-year follow- up data are shown.

RESULTS AND CONCLUSIONS: In one-year period MIDLF was applied for 9 patients. For all cases motor deficits improved, pain decreased from a high VAS score to VAS 1. No complications were seen so far. In one case small pedicles prevented the use of MIDLF technique. Operative time, acceptable hemoglobin loss, short length of stay and encouraging follow-up result indicate that this technique is a valid option to improve patient's quality of life where osteoporosis makes traditional trans-pedicular screws less stable or where the surgeon has the need to reduce intraoperative blood loss or has to work in a deep surgical field.