Lo Wei-Lun, Lin Chien-Min, Yeh Yi-Shian, Su Yu-Kai, Tseng Yuan-Yun, Yang Shun-Tai, Lin Jai-Wei
Department of Neurosurgery, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan ; Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan ; Taipei Medical University, Taipei, Taiwan.
Department of Neurosurgery, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan ; Taipei Medical University, Taipei, Taiwan ; University of Fukui Faculty of Medical Sciences, Fukui, Japan.
Biomed Res Int. 2015;2015:168384. doi: 10.1155/2015/168384. Epub 2015 Jan 5.
Degenerative diseases of the lumbar spine, which are common among elderly people, cause back pain and radicular symptoms and lead to a poor quality of life. Lumbar spinal fusion is a standardized and widely accepted surgical procedure used for treating degenerative lumbar diseases; however, the classical posterior approach used in this procedure is recognized to cause vascular and neurologic damage of the lumbar muscles. Various studies have suggested that using the minimally invasive transforaminal interbody fusion (TLIF) technique provides long-term clinical outcomes comparable to those of open TLIF approaches in selected patients. In this study, we compared the perioperative and short-term advantages of miniopen, MI, and open TLIF. Compared with open TLIF, MI-TLIF and miniopen TLIF were associated with less blood loss, shorter hospital stays, and longer operative times; however, following the use of these procedures, no difference in quality of life was measured at 6 months or 1 year. Whether miniopen TLIF or MI-TLIF can replace traditional TLIF as the surgery of choice for treating degenerative lumbar deformity remains unclear, and additional studies are required for validating the safety and efficiency of these procedures.
腰椎退行性疾病在老年人中很常见,会引起背痛和神经根症状,导致生活质量下降。腰椎融合术是一种用于治疗退行性腰椎疾病的标准化且被广泛接受的外科手术;然而,该手术中使用的经典后路方法被认为会导致腰椎肌肉的血管和神经损伤。各种研究表明,在特定患者中,使用微创经椎间孔腰椎椎体间融合术(TLIF)技术可提供与开放TLIF方法相当的长期临床效果。在本研究中,我们比较了微创开放、微创和开放TLIF的围手术期和短期优势。与开放TLIF相比,微创TLIF和微创开放TLIF的失血量更少、住院时间更短、手术时间更长;然而,在使用这些手术后,6个月或1年时生活质量没有差异。微创开放TLIF或微创TLIF是否能取代传统TLIF作为治疗退行性腰椎畸形的首选手术尚不清楚,需要更多研究来验证这些手术的安全性和有效性。