Artikel
Preliminary clinical and radiological outcomes of open versus minimally invasive transforaminal lumbar interbody fusion for single-level lumbar degenerative disease
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Veröffentlicht: | 21. Mai 2013 |
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Gliederung
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Objective: Comparing and analyzing clinical and radiological outcomes of open versus minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for single-level lumbar degenerative disease.
Method: From February 2010 to February 2011, 147 single-level open and MIS TLIF were performed at our centre and were followed up more than 1.5 years. 34 cases underwent MIS-TLIF as study group and 113 cases underwent traditional open TLIF as control group. In the study group, mild spondylolisthesis was observed in 12, lumbar vertebrae unsteady in 7 and lumbar stenosis in 15 patients, All underwent single-level MIS-TLIF with single cage through MLDS (Micro Lumbar Distractor System) using the Wiltse approach. In the control group, mild spondylolisthesis was detected in 48, lumbar vertebrae unsteady in 10 and lumbar stenosis in 53 patients. All underwent single-level open-TLIF with single cage. Comparing and analyzing clinical and radiological outcomes of both groups such as the length of incision, operation time, the blood loss intra-operatively, post-operative hospital stay, post-operative complications, fusion rate, cage dislocation and subsidence and, the postoperative VAS and ODI t after 1, 3 and 18 months.
Results: There was no significant difference in pre-operative status between two groups. Patients of the MIS-TLIF study group turned out to have significant advantages over the OPEN-TLIF group in the length of incision, the blood loss intra-operatively and the post-operative hospital stay (p<0.05). There was no significant difference in operation time. Regarding the early clinical outcome the MIS-TLIF group was superior to the OPEN-TLIF group in VAS and ODI 1 and 3 months postoperative. However, there was no significant difference in the long-term outcome of VAS and ODI 18 months postoperative (p>0.05) between two groups.
Conclusions: MIS-TLIF surgical technique is a safe and reliable method. It has some advantages such as less invasivness, quick recovery and may partially replace OPEN-TLIF.