Brisbane Clinical Neuroscience Centre, The Mater Private Hospital, The Mater Neuroscience Centre, 550 Stanley Street, Suite 5.02 Mater Private Clinic, South Brisbane, Queensland 4101, Australia.
J Clin Neurosci. 2012 Jun;19(6):858-61. doi: 10.1016/j.jocn.2011.10.007. Epub 2012 Mar 2.
The purpose of this study was to assess the clinical and radiological outcomes of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) surgery for lumbar spondylolisthesis. A prospective analysis was conducted of 23 consecutive patients with grade I or grade II lumbar spondylolisthesis who underwent a MI-TLIF using image guidance between August 2008 and September 2010. The patient group comprised 13 males and 10 females (mean age 57 years), 22 of whom underwent single level fusion and one patient with a two level fusion. All patients underwent postoperative CT scans to assess pedicle screw and cage placement and fusion at six months. The Oswestry Disability Index (ODI) scores were recorded preoperatively and at the six-month follow-up. We found that 22 of 23 (95.7%) patients showed evidence of fusion at six months with a mean improvement of 26.7 on ODI scores. The mean length of hospital stay was four days. The mean operative time was 172 minutes. Anatomical reduction of the spondylolisthesis was complete in 16 patients and incomplete in seven. Regarding complications, we observed: one of 94 (1.1%) pedicle screws misplaced, which did not require revision postoperatively; one of 23 patients (4.3%) with a pulmonary embolism and one of 23 (4.3%) patients with transient nerve root pain. There were no occurrences of infection and no postoperative cerebrospinal fluid leaks. We conclude that MI-TLIF offers patients a safe and effective surgical option for lumbar spondylolisthesis treatment. Furthermore, it may offer patients additional advantages in terms of postoperative pain and recovery.
本研究旨在评估微创经椎间孔腰椎体间融合术（MI-TLIF）治疗腰椎滑脱症的临床和影像学结果。对 2008 年 8 月至 2010 年 9 月间采用影像引导行 MI-TLIF 的 23 例 I 或 II 度腰椎滑脱患者进行前瞻性分析。患者组包括 13 例男性和 10 例女性（平均年龄 57 岁），其中 22 例行单节段融合，1 例行双节段融合。所有患者术后均行 CT 扫描评估椎弓根螺钉和 cage 位置以及 6 个月时的融合情况。记录术前和 6 个月随访时的 Oswestry 功能障碍指数（ODI）评分。我们发现，23 例患者中有 22 例（95.7%）在 6 个月时显示融合证据，ODI 评分平均改善 26.7。平均住院时间为 4 天，平均手术时间为 172 分钟。16 例患者的滑脱完全复位，7 例患者不完全复位。关于并发症，我们观察到：94 例中有 1 例（1.1%）椎弓根螺钉位置不当，术后无需修正；23 例中有 1 例（4.3%）肺栓塞和 23 例中有 1 例（4.3%）神经根痛短暂。无感染和术后脑脊液漏发生。我们得出结论，MI-TLIF 为腰椎滑脱症患者提供了一种安全有效的手术选择。此外，它可能为患者提供术后疼痛和恢复方面的额外优势。
