2026 SICOT Annual Meeting: MIS-TLIF vs open TLIF in combined lumbar stenosis and low-grade spondylolisthesis: Of discharge timing and pricing

Patients with symptomatic lumbar spinal stenosis and low-grade degenerative spondylolisthesis were randomized to receive minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) or open transforaminal lumbar interbody fusion (TLIF). The primary outcome was the change in Oswestry Disability Index (ODI) score from baseline to 3 months, using a non-inferiority margin of 12 points. Secondary outcomes included back and leg pain, neuropathic pain, treatment satisfaction, perioperative outcomes, complications, and cost-effectiveness. Outcomes were assessed at 3 months postoperatively. Overall, the results demonstrated that MIS-TLIF was non-inferior to open TLIF for improving disability, with a mean between-group difference of 0.4 points (90% CI −5.7 to 6.5). Although open TLIF was associated with longer hospitalization and greater analgesic requirements, MIS-TLIF incurred higher direct costs. These findings suggest that both approaches provide comparable short-term clinical benefits, with important differences in resource utilization.