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比较微创经椎间孔腰椎椎体间融合术和后路腰椎椎体间融合术治疗腰椎滑脱症:一项符合STROBE标准的观察性研究。

Comparing minimally invasive transforaminal lumbar interbody fusion and posterior lumbar interbody fusion for spondylolisthesis: A STROBE-compliant observational study.

作者信息

Zhang Dapeng, Mao Keya, Qiang Xiaojun

机构信息

Puyang Oilfield General Hospital, Puyang Department of Orthopaedics, Chinese PLA General Hospital (301 Hospital), Beijing, PR China.

出版信息

Medicine (Baltimore). 2017 Sep;96(37):e8011. doi: 10.1097/MD.0000000000008011.

Abstract

Although spondylolisthesis was traditionally treated with posterior lumbar interbody fusion (PLIF), minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) was recently proposed as an alternative treatment for spondylolisthesis. However, no studies have focused on the comparison of these 2 techniques' outcome on spondylolisthesis.The operative reports and perioperative data of patients who underwent single-level primary open PLIF (n = 29) and MIS-TLIF (n = 26) for I/II spondylolisthesis were retrospectively evaluated. Patients' demographics, operative blood loss, hospital length of stay, creatine kinase (CK) level, radiographic fusion, complications, and patient-reported outcomes were evaluated. Radiographic fusion was assessed using the Bridwell grading criteria. Preoperative and postoperative patient-reported outcomes included the visual analog scale (VAS) and Oswestry Disability Index (ODI).Average follow-up was 28 ± 3.6 months (range 24-32 months). Bed rest time, hospital stay, estimated blood loss, and operative time in the MIS-TLIF group were significantly lower than those in the PLIF group (P < .05). The 3-month postoperative ODI and VAS in the MIS-TLIF group were significantly better than the PLIF group (P < .05). However, at the time of the last follow-up, both groups had similar ODI scores and complication, slip reduction, and spinal fusion rates (P > .05).Compared with PLIF, MIS-TLIF for grade I/II spondylolisthesis can achieve similar reduction and fusion results with better short-term quality of life, shorter hospital stays, less estimated blood loss, and shorter operative times.

摘要

虽然传统上腰椎滑脱采用后路腰椎椎间融合术(PLIF)治疗,但近年来微创经椎间孔腰椎椎间融合术(MIS-TLIF)被提议作为腰椎滑脱的替代治疗方法。然而,尚无研究聚焦于比较这两种技术治疗腰椎滑脱的效果。我们回顾性评估了因I/II度腰椎滑脱接受单节段初次开放PLIF(n = 29)和MIS-TLIF(n = 26)治疗患者的手术报告和围手术期数据。评估了患者的人口统计学特征、术中失血量、住院时间、肌酸激酶(CK)水平、影像学融合情况、并发症以及患者报告的结局。使用Bridwell分级标准评估影像学融合情况。术前和术后患者报告的结局包括视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)。平均随访时间为28±3.6个月(范围24 - 32个月)。MIS-TLIF组的卧床休息时间、住院时间、估计失血量和手术时间均显著低于PLIF组(P < 0.05)。MIS-TLIF组术后3个月的ODI和VAS显著优于PLIF组(P < 0.05)。然而,在末次随访时,两组的ODI评分、并发症、滑脱复位率和脊柱融合率相似(P > 0.05)。与PLIF相比,I/II度腰椎滑脱的MIS-TLIF可获得相似的复位和融合效果,且短期生活质量更好,住院时间更短,估计失血量更少,手术时间更短。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec7c/5604652/0165ba9ec4b9/medi-96-e8011-g001.jpg

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