Lv You, Chen Jingyang, Chen Jinchuan, Wu Yuling, Chen Xiangyang, Liu Yi, Chu Zhaoming, Sheng Luxin, Qin Rujie, Chen Ming
a Department of Orthopedics , The First People's Hospital of Lianyungang , Jiangsu , China.
b Department of Orthopedics , Ningbo Medical Center Lihuili Eastern Hosipital , Zhejiang , China.
Minim Invasive Ther Allied Technol. 2017 Jun;26(3):168-176. doi: 10.1080/13645706.2016.1273837. Epub 2017 Jan 13.
The aim of this study is to assess the long-term clinical and radiological outcomes between minimally invasive (MIS) and conventional transforaminal lumbar interbody fusion (TLIF) in treating one-segment lumbar disc herniation (LDH).
One-hundred and six patients treated by MIS-TLIF (50 cases) or conventional TLIF (56 cases) were included. Perioperative results were evaluated. Clinical outcomes were compared preoperatively and postoperatively. Radiologic parameters were based on a comparison of preoperative and three-year postoperative lumbar lordosis, segmental lordosis, sacral slope, the cross-sectional area of the paraspinal muscle and fusion rates.
MIS TILF had significantly less blood, shorter operation time, mean return to work time and lower intramuscular pressure compared with the conventional group during the operation. VAS scores for lower back pain and ODI in MIS-TLIF were significantly decreased. The mean cross-sectional area of the paraspinal muscle was significantly decreased after surgery in the conventional TLIF group and no significant intragroup differences were established in the MIS-TLIF group. No significant differences were found in fusion rate, lumbar lordosis, segmental lordosis and sacral slope.
Both MIS and conventional TLIF were beneficial for patients with LDH. However, MIS-TLIF manifests a great improvement in perioperative outcomes, low back pain, disability and preventing paraspinal muscle atrophy during the follow-up period observation.
本研究旨在评估微创（MIS）与传统经椎间孔腰椎椎体间融合术（TLIF）治疗单节段腰椎间盘突出症（LDH）的长期临床和影像学结果。
纳入106例接受MIS-TLIF（50例）或传统TLIF（56例）治疗的患者。评估围手术期结果。比较术前和术后的临床结果。放射学参数基于术前与术后三年腰椎前凸、节段性前凸、骶骨倾斜度、椎旁肌横截面积和融合率的比较。
与传统组相比，MIS TLIF在手术期间出血量显著减少，手术时间、平均恢复工作时间缩短，肌肉内压力降低。MIS-TLIF组下腰痛的视觉模拟评分（VAS）和腰椎间盘突出症功能障碍指数（ODI）显著降低。传统TLIF组术后椎旁肌平均横截面积显著减小，而MIS-TLIF组组内无显著差异。融合率、腰椎前凸、节段性前凸和骶骨倾斜度方面未发现显著差异。
MIS和传统TLIF对LDH患者均有益。然而，在随访观察期间，MIS-TLIF在围手术期结果、腰痛、残疾以及预防椎旁肌萎缩方面表现出极大改善。
