Gatam Asrafi Rizki, Gatam Luthfi, Mahadhipta Harmantya, Ajiantoro Ajiantoro, Luthfi Omar, Aprilya Dina
Orthopaedic Spine Division, Fatmawati General Hospital, Jakarta, Indonesia.
Orthopaedic Spine Division, Tangerang General Hospital, Banten, Indonesia.
Orthop Res Rev. 2021 Nov 24;13:229-239. doi: 10.2147/ORR.S336479. eCollection 2021.
In the past few decades, the minimally invasive technique for spine surgery has developed extensively from the scope of decompression until fusion surgeries to reduce damages to the normal anatomical structure. Unilateral biportal endoscopic lumbar interbody fusion (ULIF) is one of the fusion options which is readily available without a sophisticated minimal invasive instrument. Our aim is to introduce ULIF experience in our center and comparing the result with conventional minimally invasive lumbar interbody fusion (MIS-TLIF).
This is a retrospective cohort study of 145 lumbar spondylolisthesis cases that underwent fusion surgery with either ULIF or the conventional MIS-TLIF. All of the patients were observed within a 12-month follow-up period to evaluate the back pain and leg pain Visual Analogue Score (VAS), the Oswestry Disability Index (ODI), the 36-Item Short Form Health Survey (SF-36), and fusion rate.
The leg pain VAS was similarly improved in both groups. ULIF has a significant back pain improvement on direct post operation and at the 3-months follow-up ( value 0.032 and 0.046 respectively). ULIF group also had a significantly better improvement of ODI scores on the early post-operative period (=0.045). However, both groups similarly showed improvement of ODI score and the SF-36 at the 3-, 6-, and 12- months follow up.
Full endoscopic fusion surgery with ULIF offers a comparable long-term outcome and a significantly better back pain VAS reduction in short-term follow up compared to the conventional MIS-TLIF. ULIF, with further improvement, can be the next gold standard in managing degenerative lumbar spine conditions.
在过去几十年中，脊柱外科的微创技术已从减压手术广泛发展到融合手术，以减少对正常解剖结构的损伤。单侧双通道内镜下腰椎椎间融合术（ULIF）是一种融合手术选择，无需复杂的微创器械即可实施。我们的目的是介绍我们中心的ULIF经验，并将结果与传统的微创腰椎椎间融合术（MIS-TLIF）进行比较。
这是一项对145例腰椎滑脱病例进行的回顾性队列研究，这些病例接受了ULIF或传统MIS-TLIF融合手术。对所有患者进行了为期12个月的随访，以评估背痛和腿痛视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）、简明健康调查问卷（SF-36）以及融合率。
两组的腿痛VAS均有类似改善。ULIF在术后即刻和3个月随访时背痛有显著改善（分别为P值0.032和0.046）。ULIF组在术后早期ODI评分的改善也显著更好（P = 0.045）。然而，两组在3个月、6个月和12个月随访时ODI评分和SF-36均有类似改善。
与传统的MIS-TLIF相比，采用ULIF的全内镜融合手术具有相当的长期疗效，且在短期随访中背痛VAS的降低明显更好。随着进一步改进，ULIF可能成为治疗退行性腰椎疾病的下一个金标准。
