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在微创经椎间孔腰椎椎间融合术后,静态与可扩张装置提供相似的临床结果。

Static Versus Expandable Devices Provide Similar Clinical Outcomes Following Minimally Invasive Transforaminal Lumbar Interbody Fusion.

作者信息

Khechen Benjamin, Haws Brittany E, Patel Dil V, Yoo Joon S, Guntin Jordan A, Cardinal Kaitlyn L, Iyer Sravisht, Singh Kern

机构信息

Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St. Suite #300, Chicago, IL 60612 USA.

出版信息

HSS J. 2020 Feb;16(1):46-53. doi: 10.1007/s11420-019-09677-z. Epub 2019 Mar 27.

Abstract

BACKGROUND

Few studies have analyzed differences in radiographic parameters and patient-reported outcomes (PROs) between expandable and static interbody devices in patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).

QUESTIONS/PURPOSES: To evaluate differences in radiographic parameters and PROs following MIS TLIF between static and expandable interbody devices.

METHODS

Patients undergoing primary, single-level MIS TLIF between 2014 and 2017 were retrospectively identified. Radiographic measurements including lumbar lordosis (LL), segmental lordosis (SL), disc height (DH), and foraminal height (FH) were performed on lateral radiographs before and after MIS TLIF with a static or expandable articulating interbody device. Radiographic outcomes and PROs were compared using paired and unpaired Student's test.

RESULTS

Thirty patients received expandable interbody devices and 30 patients received static interbody devices. The expandable device cohort exhibited significantly greater improvement in DH and FH at final follow-up compared with those receiving a static device. Both device cohorts experienced significant improvements in PROs at 6 months post-operatively.

CONCLUSION

MIS TLIF with an expandable interbody device led to a greater increase of DH and FH than with a static interbody device. Patients undergoing MIS TLIF can expect similar improvements in PROs whether receiving a static or an expandable interbody device. Further studies are required to better understand improvements in clinical outcomes afforded by expandable interbody devices.

摘要

背景

很少有研究分析在接受微创经椎间孔腰椎椎间融合术(MIS TLIF)的患者中,可扩张式与静态椎间融合器在影像学参数和患者报告结局(PROs)方面的差异。

问题/目的:评估静态和可扩张式椎间融合器在MIS TLIF术后的影像学参数和PROs差异。

方法

回顾性纳入2014年至2017年间接受初次单节段MIS TLIF的患者。在使用静态或可扩张式椎间融合器进行MIS TLIF术前和术后,对侧位X线片进行影像学测量,包括腰椎前凸(LL)、节段性前凸(SL)、椎间盘高度(DH)和椎间孔高度(FH)。使用配对和非配对学生t检验比较影像学结果和PROs。

结果

30例患者接受可扩张式椎间融合器,30例患者接受静态椎间融合器。与接受静态融合器的患者相比,可扩张式融合器组在末次随访时DH和FH改善更为显著。两组患者术后6个月PROs均有显著改善。

结论

与静态椎间融合器相比,使用可扩张式椎间融合器进行MIS TLIF可使DH和FH有更大增加。接受MIS TLIF的患者,无论使用静态还是可扩张式椎间融合器,PROs均可得到相似改善。需要进一步研究以更好地了解可扩张式椎间融合器对临床结局的改善情况。

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