Serban Daniel, Calina Niki, Tender Gabriel
Bagdasar-Arseni Clinical Hospital, Bucharest, Romania.
Louisiana State University, New Orleans, LA, USA.
Biomed Res Int. 2017;2017:7236970. doi: 10.1155/2017/7236970. Epub 2017 Jun 15.
Symptomatic spondylolisthesis patients may benefit from surgical decompression and stabilization. The standard (S) technique is a transforaminal lumbar interbody fusion (TLIF). Newer, minimally invasive (MI) techniques seem to provide similar results with less morbidity. We enrolled patients with at least 6 months of symptoms and image-confirmed low-grade spondylolisthesis, at a single academic institution, between 2011 and 2015. The patients were randomized to either S or MI TLIF. The primary outcome measure was the Oswestry Disability Index (ODI) improvement at 1 year. Secondary outcome measures included length of operation, estimated blood loss, length of hospitalization, and fusion rates at 1 year. Forty patients were enrolled in each group. The differences in mean operative time and estimated blood loss were not statistically significant between the two groups. The patients were discharged after surgery at 4.12 days for the S TLIF group and 1.92 days for the MI TLIF group. The ODI improvement was similar and statistically significant in both groups. The fusion was considered solid in 36 (90%) of patients at 1 year in both groups. In conclusion, the two techniques provided similar clinical and radiological outcomes at 1 year. The patients undergoing MI TLIF had a shorter hospital stay. This trial is registered with NCT03155789.
有症状的腰椎滑脱患者可能从手术减压和稳定手术中获益。标准（S）技术是经椎间孔腰椎椎间融合术（TLIF）。更新的微创（MI）技术似乎能提供相似的结果，且并发症更少。2011年至2015年期间，我们在一家学术机构招募了有至少6个月症状且经影像学证实为低度腰椎滑脱的患者。患者被随机分为S组或MI TLIF组。主要结局指标是1年时Oswestry功能障碍指数（ODI）的改善情况。次要结局指标包括手术时长、估计失血量、住院时长以及1年时的融合率。每组纳入40例患者。两组之间平均手术时间和估计失血量的差异无统计学意义。S TLIF组患者术后4.12天出院，MI TLIF组患者术后1.92天出院。两组ODI的改善情况相似且具有统计学意义。两组在1年时均有36例（90%）患者的融合被认为是稳固的。总之，两种技术在1年时提供了相似的临床和影像学结果。接受MI TLIF的患者住院时间更短。该试验已在ClinicalTrials.gov上注册，注册号为NCT03155789。
