Zhang Hao, Zhou Chuanli, Wang Chao, Zhu Kai, Tu Qihao, Kong Meng, Zhao Chong, Ma Xuexiao
Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People's Republic of China.
Int J Gen Med. 2021 Feb 22;14:549-558. doi: 10.2147/IJGM.S298591. eCollection 2021.
To compare the preliminary postoperative outcomes of percutaneous endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of lumbar spondylolisthesis.
Sixty-two patients with single-segment lumbar spondylolisthesis received Endo-TLIF and MIS-TLIF were enrolled in present study. Perioperative parameters, including operation time, estimated blood loss (EBL), interoperative fluoroscopy time, ambulation time and operative complications were recorded, respectively. The results of clinical metrics such as the Visual Analog Scale (VAS) for back and leg pain, the Oswestry Disability Index (ODI) and the Japanese Orthopaedic Association (JOA) score were obtained, respectively. Postoperative fusion rates were assessed by clinical fusion and CT at 12-month after surgery.
No significant differences were found in the demographic data between the two groups. Compared with MIS-TLIF group, Endo-TLIF group had similar operative time, less intraoperative blood loss and shorter ambulation time but longer duration of X-ray radiation. The postoperative VAS scores of back pain, ODI and JOA score were significantly improved comparing with the preoperative scores in two groups, but the Endo-TLIF group showed more significant improvement in the early follow-up (P < 0.05, respectively). There were no significant differences in terms of the interbody fusion rate between the two groups. Meanwhile, no serious postoperative complications were observed in the study.
Compared with MIS-TLIF, Endo-TLIF technique showed relatively faster recovery and better outcomes in terms of early curative effect, especially in 6 months after operation. However, intraoperative repeated fluoroscopy could result in highly cumulative radiation and longer operation time.
比较经皮内镜下经椎间孔腰椎椎间融合术（Endo-TLIF）与微创经椎间孔腰椎椎间融合术（MIS-TLIF）治疗腰椎滑脱症的术后早期疗效。
本研究纳入62例接受Endo-TLIF和MIS-TLIF治疗的单节段腰椎滑脱症患者。分别记录围手术期参数，包括手术时间、估计失血量（EBL）、术中透视时间、下床活动时间及手术并发症。分别获取临床指标结果，如背部和腿部疼痛的视觉模拟量表（VAS）、Oswestry功能障碍指数（ODI）和日本骨科学会（JOA）评分。术后12个月通过临床融合和CT评估融合率。
两组患者的人口统计学数据无显著差异。与MIS-TLIF组相比，Endo-TLIF组手术时间相近，术中失血量少，下床活动时间短，但X线辐射时间长。两组术后背痛VAS评分、ODI及JOA评分与术前相比均显著改善，但Endo-TLIF组在早期随访中改善更显著（P均<0.05）。两组椎间融合率无显著差异。同时，本研究未观察到严重的术后并发症。
与MIS-TLIF相比，Endo-TLIF技术在早期疗效方面恢复相对较快，效果更好，尤其是在术后6个月。然而，术中反复透视会导致辐射累积量高，手术时间延长。
