Zhang Dapeng, Mao Keya, Qiang Xiaojun
Puyang Oilfield General Hospital, Puyang Department of Orthopaedics, Chinese PLA General Hospital (301 Hospital), Beijing, PR China.
Medicine (Baltimore). 2017 Sep;96(37):e8011. doi: 10.1097/MD.0000000000008011.
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.
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。