{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T14:39:38Z","timestamp":1776695978720,"version":"3.51.2"},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:p>In the conventional posterior approach to the lumbar spine for transforaminal lumbar interbody fusion (TLIF), the paravertebral muscles are stripped from the spinous process. The authors developed a novel surgical procedure in which TLIF was performed via a modified spinous process\u2013splitting (SPS) approach that enabled the preservation of the attachment of the paravertebral muscles to the spinous process. The SPS TLIF group comprised 52 patients with lumbar degenerative or isthmic spondylolisthesis who underwent surgery using a modified SPS TLIF technique, whereas the control group comprised 54 patients who underwent conventional TLIF. Compared with the control group, the SPS TLIF group had a significantly shorter operation time, smaller intra- and postoperative blood loss volumes, and shorter hospital stay and time to ambulation (p &lt; 0.05). The SPS TLIF group had a lower mean visual analog scale score for back pain than the control group on both postoperative day 3 and at 2 years postoperatively (p &lt; 0.05). Follow-up MRI showed changes in the paravertebral muscles in 46 of 54 patients (85%) in the control group and 5 of 52 patients (10%) in the SPS TLIF group (p &lt; 0.001). This novel technique may be a useful alternative to the conventional posterior approach for TLIF.<\/jats:p>","DOI":"10.3171\/2023.4.spine2322","type":"journal-article","created":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T15:46:28Z","timestamp":1684597588000},"page":"387-393","source":"Crossref","is-referenced-by-count":6,"title":["Clinical outcomes of transforaminal lumbar interbody fusion using a modified posterior spinous process\u2013splitting approach for lumbar degenerative or isthmic spondylolisthesis: a prospective cohort study"],"prefix":"10.3171","volume":"39","author":[{"given":"Guanyi","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Ningbo No. 6 Hospital, Ningbo, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lihua","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Ningbo No. 6 Hospital, Ningbo, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Ningbo No. 6 Hospital, Ningbo, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Ningbo No. 6 Hospital, Ningbo, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weihu","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Ningbo No. 6 Hospital, Ningbo, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"15 suppl","key":"b1","series-title":"Spine (Phila Pa 1976)","first-page":"S26","article-title":"Minimally invasive lumbar fusion","volume":"28","author":"Foley KT","year":"2003","unstructured":"Foley KT, Holly LT, Schwender JD. Minimally invasive lumbar fusion. Spine (Phila Pa 1976). 2003;28(15 suppl):S26-S35."},{"issue":"12","key":"b2","series-title":"Spine J","first-page":"2049","article-title":"Long-term clinical outcome of minimally invasive versus open single-level transforaminal lumbar interbody fusion for degenerative lumbar diseases: a meta-analysis","volume":"21","author":"Heemskerk JL","year":"2021","unstructured":"Heemskerk JL, Oluwadara Akinduro O, Clifton W, Qui\u00f1ones-Hinojosa A, Abode-Iyamah KO. Long-term clinical outcome of minimally invasive versus open single-level transforaminal lumbar interbody fusion for degenerative lumbar diseases: a meta-analysis. Spine J. 2021;21(12):2049\u20132065."},{"issue":"5","key":"b3","series-title":"J Neurosurg Spine","first-page":"694","article-title":"A novel surgical approach to the lumbar spine involving hemilateral split-off of the spinous process to preserve the multifidus muscle: technical note","volume":"24","author":"Chatani K","year":"2016","unstructured":"Chatani K. A novel surgical approach to the lumbar spine involving hemilateral split-off of the spinous process to preserve the multifidus muscle: technical note. J Neurosurg Spine. 2016;24(5):694\u2013699."},{"issue":"10","key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"1023","article-title":"Serial changes in trunk muscle performance after posterior lumbar surgery","volume":"24","author":"Gejo R","year":"1999","unstructured":"Gejo R, Matsui H, Kawaguchi Y, Ishihara H, Tsuji H. Serial changes in trunk muscle performance after posterior lumbar surgery. Spine (Phila Pa 1976). 1999;24(10):1023\u20131028."},{"issue":"8","key":"b5","series-title":"Spine (Phila Pa 1976)","first-page":"E276","article-title":"Muscle-preserving interlaminar decompression for the lumbar spine: a minimally invasive new procedure for lumbar spinal canal stenosis","volume":"34","author":"Hatta Y","year":"2009","unstructured":"Hatta Y, Shiraishi T, Sakamoto A,  Muscle-preserving interlaminar decompression for the lumbar spine: a minimally invasive new procedure for lumbar spinal canal stenosis. Spine (Phila Pa 1976). 2009;34(8):E276\u2013E280."},{"issue":"22","key":"b6","series-title":"Spine (Phila Pa 1976)","first-page":"2598","article-title":"Back muscle injury after posterior lumbar spine surgery. Part 2: Histologic and histochemical analyses in humans","volume":"19","author":"Kawaguchi Y","year":"1994","unstructured":"Kawaguchi Y, Matsui H, Tsuji H. Back muscle injury after posterior lumbar spine surgery. Part 2: Histologic and histochemical analyses in humans. Spine (Phila Pa 1976). 1994;19(22):2598\u20132602."},{"issue":"8","key":"b7","series-title":"Clin Spine Surg","first-page":"E439","article-title":"Decompression of lumbar central spinal canal stenosis following minimally invasive transforaminal lumbar interbody fusion","volume":"34","author":"Khalifeh JM","year":"2021","unstructured":"Khalifeh JM, Massie LW, Dibble CF,  Decompression of lumbar central spinal canal stenosis following minimally invasive transforaminal lumbar interbody fusion. Clin Spine Surg. 2021;34(8):E439\u2013E449."},{"issue":"3","key":"b8","series-title":"J Neurosurg Spine","first-page":"229","article-title":"Split-spinous process laminotomy and discectomy for degenerative lumbar spinal stenosis: a preliminary report","volume":"6","author":"Cho DY","year":"2007","unstructured":"Cho DY, Lin HL, Lee WY, Lee HC. Split-spinous process laminotomy and discectomy for degenerative lumbar spinal stenosis: a preliminary report. J Neurosurg Spine. 2007;6(3):229\u2013239."},{"issue":"4","key":"b9","series-title":"J Neurosurg Spine","first-page":"353","article-title":"Surgical outcomes of modified lumbar spinous process-splitting laminectomy for lumbar spinal stenosis","volume":"22","author":"Kanbara S","year":"2015","unstructured":"Kanbara S, Yukawa Y, Ito K, Machino M, Kato F. Surgical outcomes of modified lumbar spinous process-splitting laminectomy for lumbar spinal stenosis. J Neurosurg Spine. 2015;22(4):353\u2013357."},{"issue":"23","key":"b10","series-title":"Spine (Phila Pa 1976)","first-page":"E1461","article-title":"Modified Marmot operation versus spinous process transverse cutting laminectomy for lumbar spinal stenosis","volume":"38","author":"Kawakami M","year":"2013","unstructured":"Kawakami M, Nakao S, Fukui D, Kadosaka Y, Matsuoka T, Yamada H. Modified Marmot operation versus spinous process transverse cutting laminectomy for lumbar spinal stenosis. Spine (Phila Pa 1976). 2013;38(23):E1461\u2013E1468."},{"issue":"2","key":"b11","series-title":"Eur Spine J","first-page":"447","article-title":"Comparison of spinous process-splitting laminectomy versus posterolateral fusion for lumbar degenerative spondylolisthesis","volume":"32","author":"Kurogochi D","year":"2023","unstructured":"Kurogochi D, Uehara M, Yui M,  Comparison of spinous process-splitting laminectomy versus posterolateral fusion for lumbar degenerative spondylolisthesis. Eur Spine J. 2023;32(2):447\u2013454."},{"issue":"2","key":"b12","series-title":"J Neurosurg Spine","first-page":"187","article-title":"Clinical outcome of microscopic lumbar spinous process-splitting laminectomy: clinical article","volume":"21","author":"Nomura H","year":"2014","unstructured":"Nomura H, Yanagisawa Y, Arima J, Oga M. 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J Neurosurg Spine","first-page":"405","article-title":"Lumbar spinous process-splitting laminectomy for lumbar canal stenosis","volume":"3","author":"Watanabe K","year":"2005","unstructured":"Watanabe K, Hosoya T, Shiraishi T, Matsumoto M, Chiba K, Toyama Y. Lumbar spinous process-splitting laminectomy for lumbar canal stenosis. Technical note. J Neurosurg Spine. 2005;3(5):405\u2013408."},{"issue":"1","key":"b15","series-title":"J Neurosurg Spine","first-page":"51","article-title":"Reduced postoperative wound pain after lumbar spinous process-splitting laminectomy for lumbar canal stenosis: a randomized controlled study","volume":"14","author":"Watanabe K","year":"2011","unstructured":"Watanabe K, Matsumoto M, Ikegami T,  Reduced postoperative wound pain after lumbar spinous process-splitting laminectomy for lumbar canal stenosis: a randomized controlled study. 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J Jpn Orthop Assoc. 1986;60:393\u2013394."},{"issue":"4","key":"b18","series-title":"Eur Spine J","first-page":"745","article-title":"Spinous process-splitting open pedicle screw fusion provides favorable results in patients with low back discomfort and pain compared to conventional open pedicle screw fixation over 1 year after surgery","volume":"21","author":"Mori E","year":"2012","unstructured":"Mori E, Okada S, Ueta T,  Spinous process-splitting open pedicle screw fusion provides favorable results in patients with low back discomfort and pain compared to conventional open pedicle screw fixation over 1 year after surgery. Eur Spine J. 2012;21(4):745\u2013753."},{"issue":"suppl","key":"b19","series-title":"J Spinal Disord Tech","first-page":"S1","article-title":"Minimally invasive transforaminal lumbar interbody fusion (TLIF): technical feasibility and initial results","volume":"18","author":"Schwender JD","year":"2005","unstructured":"Schwender JD, Holly LT, Rouben DP, Foley KT. 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