{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T20:04:06Z","timestamp":1770062646464,"version":"3.49.0"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,2]]},"abstract":"ABSTRACT<\/jats:title>\n \n Introduction<\/jats:title>\n There are many instruments and facilities designed to facilitate the procedure of minimally invasive spine surgery. However, those current instrumentation systems may increase the complexity to accomplish the procedure. Our department developed a specific two small incision surgery for MI\u2010TLIF, and the benefits of this technique could control only one unilateral surgical incision for two\u2010screw insertion, which the length of each wound was as small as 3.0\u20134.0\u2009cm. In this retrospective study, we compared the intraoperative and postoperative results of novel two incisions technique and traditional four surgical incisions for patients with 1\u2010level MI\u2010TLIF treatment.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We retrospective recruited 80 consecutive patients who had degenerative spinal stenosis or spondylolisthesis and received primary 1\u2010level MI\u2010TLIF in single hospital from September 10, 2020, to October 19, 2023. The Wiltse approach for interbody fusion and a single\u2010plane fluoroscopy\u2010guided method to insert the pedicle screws were used. Patients were divided into two groups depending on different surgical techniques. Patient demographics, intraoperative and postoperative data were assessed. The Mann\u2013Whitney\n U<\/jats:italic>\n test or Fisher exact test were used to evaluate the data and a\n p<\/jats:italic>\n value\u2009<\u20090.05 was considered significant in this study.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 71 patients met the inclusion criteria in this study. The baseline data were similar between novel technique (\n n<\/jats:italic>\n \u2009=\u200941, two incisions) and traditional MI\u2010TLIF group (\n n<\/jats:italic>\n \u2009=\u200930, four incisions). Among all intraoperative, postoperative and complication categories, the instrumentation time was the only item that showed significant difference, which is shorter in novel technique group (\n p<\/jats:italic>\n \u2009=\u20090.034). The difference became more apparent in the obese group (BMI\u2009\u2265\u200927\u2009kg\/m\n \n 2<\/jats:styled-content>\n <\/jats:sup>\n ,\n p<\/jats:italic>\n \u2009=\u20090.01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Although the novel technique could reduce the number of surgical incisions compared to traditional MI\u2010TLIF, the intraoperative and postoperative results were similar to the traditional MI\u2010TLIF. Hence the reduction in wound number and the total length of surgical wound does not have obvious benefits in 1\u2010level MI\u2010TLIF patients. However, the less surgical exposure may offer less surgical wounds complications for specific groups, which were immune\u2010compromised, such as diabetics, chronic renal disease, or cancer patients, and the clinical follow\u2010up of specific groups will be planned to perform in the future.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/os.70245","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T11:12:24Z","timestamp":1767870744000},"page":"300-310","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Is Pedicle\u2010Screw Internal Fixation With Two Small Incisions Superior to Traditional\n MI<\/scp>\n \u2010\n TLIF<\/scp>\n With Four Incisions? Preliminary Follow\u2010Up Results"],"prefix":"10.1111","volume":"18","author":[{"given":"Yueh\u2010Ying","family":"Hsieh","sequence":"first","affiliation":[{"name":"Department of Orthopedics Shuang Ho Hospital, Taipei Medical University Taipei City Taiwan"},{"name":"Department of Orthopaedics School of Medicine, College of Medicine, Taipei Medical University Taipei City Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lien\u2010Chen","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Shuang Ho Hospital, Taipei Medical University Taipei City Taiwan"},{"name":"Department of Orthopaedics School of Medicine, College of Medicine, Taipei Medical University Taipei City Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5797-1885","authenticated-orcid":false,"given":"Fon\u2010Yih","family":"Tsuang","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery National Taiwan University Hospital Taipei City Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chia\u2010Hsien","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Shuang Ho Hospital, Taipei Medical University Taipei City Taiwan"},{"name":"Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University Taipei City Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang\u2010Jung","family":"Chiang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Shuang Ho Hospital, Taipei Medical University Taipei City Taiwan"},{"name":"Department of Orthopaedics School of Medicine, College of Medicine, Taipei Medical University Taipei City Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0b013e3181c70fe3"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.3171\/2009.12.spine09621"},{"key":"e_1_2_13_4_1","article-title":"Minimally Invasive Transforaminal Lumbar Interbody Fusion (TLIF): Technical Feasibility and Initial Results","volume":"18","author":"Schwender J. D.","year":"2005","journal-title":"Clinical Spine Surgery"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/bsd.0000000000000034"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586\u2010012\u20102281\u20104"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0b013e3182a8212d"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2013.10.053"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nec.2013.12.007"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2011.09.013"},{"key":"e_1_2_13_11_1","first-page":"3868","article-title":"Minimally Invasive Lumbar Interbody Fusion via MAST Quadrant Retractor Versus Open Surgery: A Prospective Randomized Clinical Trial","volume":"124","author":"Wang H.\u2010L.","year":"2011","journal-title":"Chinese Medical Journal"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1227\/neu.0000000000000913"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000223505.07815.74"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinimag.2005.03.001"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2017.06.022"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447\u201020130523\u201016"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000005249"},{"key":"e_1_2_13_18_1","first-page":"499","article-title":"Advances in Minimally Invasive Spine Surgery","volume":"49","author":"Foley K. 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