Artikel
Minimally invasive transforaminal lumbar interbody fusion versus oblique lateral interbody fusion at L4-5 level: A comparison of radiologic, clinical outcomes and complications
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Veröffentlicht: | 8. Juni 2016 |
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Gliederung
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Objective: There are no published studies comparing results of oblique lateral interbody fusion (OLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), which both are popular minimally invasive surgical methods. The aim of this study is to summarize the preliminary radiological outcomes OLF and MIS-TLIF at L4-5 level, as well as clinical outcomes and complications.
Method: From October 2012 to December 2014, 77 patients presenting with degenerative conditions of L4-5 vertebra underwent either OLIF with or without posterior decompression and MIS-TLIF. For radiologic outcomes, disc height (DH), lumbar lordotic angle (LLA), segmental lordotic angle (SLA), intraoperative endplate violation, subsidence during follow up were compared using computed tomography scans. Clinical outcome were compared by using visual analogue scale (VAS) and Korean version of Oswestry disability index (KODI). Transient and persistent postoperative complications were noted.
Results: 36 and 41 levels were operated by OLIF and MIS-TLIF respectively. Radiological evidence of fusion was noted in 70% and 61.5% in each group respectively at 6 months. In both groups, changes in DH between the preoperative and postoperative periods were significant (p<0.0001) with OLIF group being significantly higher. The incidence of IEV and subsidence during the course of postoperative follow-up period was higher in the MIS-TLIF group (37.5% vs 14.8% respectively p<0.001). There was no significant difference in VAS and K-ODI scores of each group. In the OLIF group there were 5 cases (13.9%) of procedure related transient complications, while MIS-TLIF group, there were no transient or persistent complications.
Conclusions: The preliminary radiological outcomes demonstrate no significant differences between groups except disc height and IEV or subsidence incidence. Clinical and functional outcomes also did not demonstrate significant differences between groups.