Saetia Kriangsak, Phankhongsab Anuchit, Kuansongtham Verapan, Paiboonsirijit Sompoch
Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2013 Jan;96(1):41-6.
To compare the clinical and radiographic outcomes between minimally invasive and open transforaminal lumbar interbody fusion (TLIF) for treatment of lumbar spondylolisthesis
A retrospective clinical study of24 consecutive cases of lumbar spondylolisthesis treated by minimally invasive TLIF (n = 12) or open TLIF (n = 12) was done at Ramathibodi Hospital between June 2008 and December 2009. The following parameters were compared between the two groups, clinical and radiographic outcomes, blood loss, operative time, length of hospital stay, and complications.
The average duration of follow-up was 28 months (range, 24 months to 38 months). There was significantly less intra-operative blood loss in minimally invasive TLIF group comparing to open TLIF group (317 cc vs. 645.83 cc: p-value = 0.04). No significant difference was observed in clinical outcomes (VAS or ODI at 2years), radiographic outcome (91.67% fusion rate in both groups), operative time (340 minutes vs. 324 minutes: p-value = 0.96) length of hospital stay (8.42 days vs. 8.33 days: p-value = 0.09) and major complication (8.33% in both groups) between the two groups.
Minimally invasive TLIF has similar clinical outcomes and fusion rate compared to open TLIF with additional benefit of less intra-operative blood loss. However the operative field of this technique is limited so thorough knowledge of anatomy in this region is required
比较微创与开放经椎间孔腰椎椎体间融合术（TLIF）治疗腰椎滑脱的临床及影像学结果
对2008年6月至2009年12月在拉玛蒂博迪医院连续接受治疗的24例腰椎滑脱患者进行回顾性临床研究，其中12例行微创TLIF，12例行开放TLIF。比较两组患者的临床及影像学结果、失血量、手术时间、住院时间及并发症等参数。
平均随访时间为28个月（范围24个月至38个月）。微创TLIF组术中失血量明显少于开放TLIF组（317 cc对645.83 cc：p值 = 0.04）。两组在临床结果（2年时的视觉模拟评分法或功能障碍指数）、影像学结果（两组融合率均为91.67%）、手术时间（340分钟对324分钟：p值 = 0.96）、住院时间（8.42天对8.33天：p值 = 0.09）及主要并发症（两组均为8.33%）方面未观察到显著差异。
与开放TLIF相比，微创TLIF具有相似的临床结果和融合率，且术中失血量更少。然而，该技术的手术视野有限，因此需要对该区域的解剖结构有透彻的了解
