Department of Spine Surgery, Peking University 4th Clinical Medical College, Beijing Jishuitan Hospital, No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035, People's Republic of China.
BMC Surg. 2022 Dec 15;22(1):429. doi: 10.1186/s12893-022-01880-w.
To perform a comparative assessment of percutaneous transfacet screws (TFS) and percutaneous bilateral pedicle screws (BPS) in oblique lateral interbody fusion (OLIF) for the treatment of single-level degenerative lumbar spine diseases in terms of radiological examinations and clinical outcomes.
Sixty-six patients who received single-level OLIF with percutaneous supplementary fixation assisted by the robot for the treatment of degenerative lumbar spine diseases were selected. There were 16 cases of OLIF with TFS and 50 cases of OLIF with BPS. The propensity score matching method selected 11 patients in each group with matched characteristics to perform a clinical comparison.
The estimated blood loss was 68.2 ± 25.2 ml in the OLIF with TFS group compared to 113.6 ± 39.3 ml in the OLIF with BPS group (P < 0.05). The intervertebral disc height raised from 8.6 to 12.9 mm in the TFS group and from 8.9 to 13.9 mm in the BPS group in the immediate postoperative period, and dropped to 10.8 and 12.9 mm at the twelfth month, respectively (P < 0.05). The fusion rates were 91% and 100% for TFS and BPS groups (P > 0.05). Quantitative assessments of back/leg pain of the two groups reached a healthy level in the late period of the follow-up.
Both TFS and BPS techniques for the OLIF surgery relieve back pain caused by degenerative lumbar spine diseases. The TFS technique exhibits less blood loss compared with the BPS. A moderate cage subsidence is present in TFS but no complication is reported.
为了比较经皮关节突螺钉(TFS)和经皮双侧椎弓根螺钉(BPS)在斜外侧椎间融合术(OLIF)治疗单节段退行性腰椎疾病中的影像学检查和临床结果,选择 66 例采用机器人辅助经皮辅助固定的单节段 OLIF 治疗退行性腰椎疾病的患者。其中 TFS 治疗 16 例,BPS 治疗 50 例。采用倾向评分匹配法选择每组 11 例具有匹配特征的患者进行临床比较。
TFS 组 OLIF 术中出血量估计为 68.2±25.2ml,BPS 组 OLIF 术中出血量为 113.6±39.3ml(P<0.05)。TFS 组术后即刻椎间盘高度从 8.6 增加到 12.9mm,BPS 组从 8.9 增加到 13.9mm,12 个月时分别降至 10.8 和 12.9mm(P<0.05)。TFS 和 BPS 组的融合率分别为 91%和 100%(P>0.05)。两组腰背/腿痛的定量评估在随访后期均达到健康水平。
TFS 和 BPS 技术均可缓解退行性腰椎疾病引起的腰痛。TFS 技术的出血量比 BPS 少。TFS 存在中等程度的椎间笼下沉,但无并发症报道。