2023 Undergraduate Research Symposium

Carly Ghanem (biological sciences), Al-Saidi, Ghanem, Salka B, Al-Saidi, Abbasi H.

Faculty mentor: Kristina Ghanem

Abstract

The standard treatment for lower back pain has been interbody fusion: Transforaminal Lumbar Interbody Fusion (TLIF). The invasive nature leads to muscle detachment and damaged nerves. To address these issues, minimally invasive (MI) TLIF techniques have been developed.

While MI TLIFs show decreased blood loss and complication rates relative to open TLIF, surgery times and long-term outcomes are reported to be similar. Oblique lateral lumbar interbody fusion (OLLIF) is a MI lumbar spinal fusion through a single 10-15 mm incision, with a faster surgery time and easier approach. Anesthesia, surgery times, and blood loss were recorded for all patients that entered into the EMR. Because no suction is used in OLLIF procedures, blood loss was measured by weighing sponges and subtracting dry weight.

To monetize the cost per minute for a hospital, a published reference was utilized and adjusted with the consumer price index. These values were reported in aggregate and stratified, based on spinal level(s) of surgery. Mann-Whitney U-tests were utilized to test the null hypothesis that the OLLIF and TLIF groups have the same or identical mean distributions for age, BMI, blood loss, and uncensored time duration variables. Data analyses were performed using IBM SPSS. A shorter length of stay than TLIF by 58.5% across all surgeries studied was found.

The trend of shorter lengths of stay remained consistent when surgeries were stratified based on the spinal level(s) involved. OLLIF also had a lower surgical admission cost than TLIF, with a difference of $6,701 versus $11,583. These findings suggest that OLLIF may be a more cost-effective and efficient alternative to TLIF for treating lower back pain, particularly for hospitals with limited resources.

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