Wu Feng Liang, Dang Lei, Zhou Hua, Yu Miao, Wei Feng, Jiang Liang, Liu Zhong Jun, Liu Xiao Guang
Department of Orthopedic Surgery, Peking University Third Hospital, Beijing 100191, China.
Biomed Environ Sci. 2020 Nov 20;33(11):839-848. doi: 10.3967/bes2020.114.
We aimed to compare the clinical and radiological outcomes of midline lumbar fusion (MIDLF) versus minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) in patients with degenerative spondylolisthesis and/or stenosis in L4-L5 two years after surgery.
Consecutively treated patients with lumbar pathology who underwent MIDLF ( = 16) and a historical control group who underwent MI-TLIF ( = 34) were included. Clinical symptoms were evaluated using Oswestry Disability Index (ODI), the 36-Item Short-Form Health Survey, and visual analog scale (VAS) scores before surgery and 3, 6, 12, and 24 months after surgery.
The mean operative time and hematocrit (HCT, Day 1) were significantly shorter and lower in MIDLF cases (174 min . 229 min, < 0.001; 0.34 . 0.36, = 0.037). The MI-TLIF group showed better improvement than the MIDLF group in ODI and VAS back and leg pain at 3 months postoperatively. VAS leg pain was higher in MIDLF than in MI-TLIF cases at 6 months. At 24 months follow-up, VAS back pain was higher in MI-TLIF than in MIDLF cases ( = 0.018).
MIDLF is comparable to MI-TLIF at L4-5 in clinical outcomes and fusion rates, and the results verified the meaningful advantage of using MIDLF for the elderly with osteoporosis.
我们旨在比较退行性腰椎滑脱和/或L4-L5节段椎管狭窄患者行中线腰椎融合术（MIDLF）与微创经椎间孔腰椎椎体间融合术（MI-TLIF）术后两年的临床和影像学结果。
纳入连续接受MIDLF治疗的腰椎疾病患者（n = 16）和接受MI-TLIF治疗的历史对照组（n = 34）。使用Oswestry功能障碍指数（ODI）、36项简短健康调查和视觉模拟量表（VAS）评分在术前以及术后3、6、12和24个月评估临床症状。
MIDLF组的平均手术时间和血细胞比容（HCT，第1天）显著更短和更低（174分钟对229分钟，P < 0.001；0.34对0.36，P = 0.037）。MI-TLIF组在术后3个月时在ODI以及VAS下腰痛和腿痛方面比MIDLF组改善更好。MIDLF组术后6个月时VAS腿痛高于MI-TLIF组。在24个月随访时，MI-TLIF组的VAS下腰痛高于MIDLF组（P = 作者：0.018）。
MIDLF在L4-5节段的临床结果和融合率方面与MI-TLIF相当，结果证实了MIDLF用于骨质疏松老年患者的显著优势。
