Lim Jae Kwan, Kim Sung Min
Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
Korean J Spine. 2013 Jun;10(2):65-71. doi: 10.14245/kjs.2013.10.2.65. Epub 2013 Jun 30.
To evaluate the radiographic results of minimally invasive (MIS) anterior lumbar interbody fusion (ALIF) and transforaminal lumbar interbody fusion (TLIF).
Twelve and nineteen patients who underwent MIS-ALIF, MIS-TLIF, respectively, from 2006 to 2008 were analyzed with a minimum 24-months' follow-up. Additionally, 18 patients treated with single level open TLIF surgery in 2007 were evaluated as a comparative group. X-rays and CT images were evaluated preoperatively, postoperatively, and at the final follow-up. Fusion and subsidence rates were determined, and radiographic parameters, including lumbar lordosis angle (LLA), fused segment angle (FSA), sacral slope angle (SSA), disc height (DH), and foraminal height (FH), were analyzed. These parameters were also compared between the open and MIS-TLIF groups.
In the MIS interbody fusion group, statistically significant increases were observed in LLA, FSA, and DH and FH between preoperative and final values. The changes in LLA, FSA, and DH were significantly increased in the MIS-ALIF group compared with the MIS-TLIF group, but SSA and FH were not significantly different. No significant differences were seen between open and MIS-TLIF except for DH. The interbody subsidence and fusion rates of the MIS groups were 12.0±4% and 96%, respectively.
Radiographic results of MIS interbody fusion surgery are as favorable as those with conventional surgery regarding fusion, restoration of disc height, foraminal height, and lumbar lordosis. MIS-ALIF is more effective than MIS-TLIF for intervertebral disc height restoration and lumbar lordosis.
评估微创前路腰椎椎间融合术（MIS-ALIF）和经椎间孔腰椎椎间融合术（MIS-TLIF）的影像学结果。
分析2006年至2008年分别接受MIS-ALIF、MIS-TLIF的12例和19例患者，随访至少24个月。此外，将2007年接受单节段开放TLIF手术的18例患者作为对照组进行评估。在术前、术后及末次随访时对X线和CT图像进行评估。确定融合率和下沉率，并分析包括腰椎前凸角（LLA）、融合节段角（FSA）、骶骨倾斜角（SSA）、椎间盘高度（DH）和椎间孔高度（FH）等影像学参数。还对开放手术组和MIS-TLIF组的这些参数进行了比较。
在MIS椎间融合术组中，术前与末次随访时LLA、FSA、DH及FH均有统计学意义的增加。与MIS-TLIF组相比，MIS-ALIF组LLA、FSA及DH的变化显著增加，但SSA和FH无显著差异。除DH外，开放手术组和MIS-TLIF组之间未见显著差异。MIS组的椎间融合器下沉率和融合率分别为12.0±4%和96%。
MIS椎间融合手术在融合、椎间盘高度恢复、椎间孔高度及腰椎前凸恢复方面的影像学结果与传统手术一样良好。MIS-ALIF在恢复椎间盘高度和腰椎前凸方面比MIS-TLIF更有效。
