Purpose
To evaluate whether the contralateral radiating pain improved after unilateral decompression and minimally invasive transforaminal lumbar interbody fusion (TLIF) in the patients with bilateral radiating pain due to degenerative lumbar disease.
Materials and Methods
Patients with the degenerative lumbar disease who underwent unilateral minimally invasive TLIF and were followed for more than 1 year were included. Clinically, low back pain and radiating pain on the dominant symptom side and the contralateral side were evaluated by the visual analogue score (VAS), and the Oswestry disability index (ODI) score was also evaluated.
Results
ODI and VAS of low back pain and radiating pain were effectively reduced in a total of 57 cases. Thirty cases having bilateral radiating pain, among these patients, unilateral decompression was performed in 15 cases and bilateral decompression thru unilateral approach in 15 patients. In unilateral decompression group, radiating pain on the dominant symptom side, and radiating pain on the contralateral side were also improved at the final followup. In 15 cases who underwent bilateral decompression, radiating pain on the dominant symptom side and the contralateral side were improved at the final follow-up. There was no significant difference between the two groups in terms of preoperative ODI, VAS of low back and radiating pain.
Conclusions
Minimally invasive TLIF via unilateral approach with or without contralateral decompression showed good clinical results in patients having unilateral or bilateral radiating pain. Minimally invasive TLIF could be an useful option even if there is bilateral radiating pain in degenerative lumbar disease.

Minimally invasive TLIF has been reported to be a useful treatment option for the patients with various degenerative lumbar diseases. Many studies have reported the favorable clinical results of MIS TLIF. However it remains technically demanding, leading to higher complication rates and longer operative times during the early period of the learning curve. It showed some potential complications due to small working space and visual field. In this study, authors tried to find out various possible complications and some tips avoiding these complications through the review of various articles and authors’ clinical experiences. In many studies, the general complication fusion rates of MIS TLIF have been reported to be similar to that of open fusion. The technical difficulty of the procedure, combined with inadequate training, is evident in initial studies of MIS TLIF. A difficult learning curve of MIS TLIF demands that surgeons have sufficient preclinical training, and education is obtained before the application of MIS TLIF in clinical practice.