Travel Distance Does Not Affect Postoperative Outcomes After 1- to 2-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion

Background: Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) is increasingly centralized and performed at high-volume specialized centers. Centralization often requires long-distance travel, but its effect on postoperative outcomes after MI-TLIF is unknown. Purpose: We sought to identify whether travel distance affects outcomes after 1- to 2-level MI-TLIF. Methods: We conducted a retrospective cohort study utilizing data from a prospectively collected registry at a single academic institution. We included adult patients who underwent primary 1- or 2-level MI-TLIF surgery between April 2017 and April 2025 by 3 board-certified orthopedic spine surgeons. Patients with <3 months of follow-up were excluded. Patients residing >50 miles from the hospital were classified as travelers. Outcome measures included Oswestry Disability Index, Visual Analog Scale, 12-Item Short Form Survey, and Patient-Reported Outcomes Measurement Information System, and their minimal clinically important difference (MCID) attainment, evaluated at ≤3 and ≥6 months. Other outcomes included 90 day and 1 year readmission and reoperation. Univariate analyses used t -tests and χ 2 /Fisher’s exact tests. Multivariable logistic regression identified predictors of long-term MCID non-achievement. Results: Of the 408 patients included, 139 (34.1%) were travelers (mean distance 440.6 vs 19.5 miles for locals). No differences were observed between travelers and locals in all primary patient-reported outcome measures or MCID attainment at both timepoints. Multivariable analysis demonstrated travel distance was not an independent predictor of long-term MCID non-achievement for any outcome 90 day and 1 year readmission and reoperation rates were similar. Conclusions: Our retrospective analysis found that in patients who underwent 1- to 2-level MI-TLIF at our institution, traveling >50 miles was not associated with inferior short- or long-term patient-reported outcomes, likelihood of achieving MCID, or rates of readmission or reoperation through 1 year follow-up. These findings suggest that patients may safely access specialized spine care at high-volume centers without outcome disadvantage from travel burden. Level of Evidence: Level III, retrospective cohort study.