Wu Pang Hung, Kim Hyeun Sung, An Jin Woo, Kim Myeonghun, Lee Inkyung, Park Jong Seon, Lee Jun Hyoung, Kang Sangsoo, Lee Jeongshik, Yi Yeonjin, Lee Jun Hyung, Park Jun Hwan, Lim Jae Hyeon, Jang Il-Tae
Spine Surgery, Nanoori Gangnam Hospital, Seoul, Korea.
Department of Orthopaedic Surgery, Juronghealth Campus, National University Health System, Singapore.
Asian Spine J. 2023 Apr;17(2):373-381. doi: 10.31616/asj.2022.0053. Epub 2023 Jan 20.
Retrospective cohort study.
Postoperative evaluation of the cross-sectional area of paraspinal muscle and clinical findings in patients who had interlaminar route uniportal full endoscopic posterolateral transforaminal lumbar interbody fusion (EPTLIF) after 2 years.
There are limited short-term follow-up studies on efficacy, safety, and physiological changes with a 2-year follow-up. There is no study on paraspinal muscle cross-sectional area change in patients who had undergone uniportal EPTLIF.
We evaluated patients who underwent EPTLIF with a minimum 24-month follow-up. Clinical parameters of the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) were measured at the preoperative, 1-week postoperative mark, postoperative 3-month mark, and final follow-up. Preoperative and 1-year postoperative magnetic resonance imaging measurement of preoperative and postoperative Kjaer grade, right and left psoas muscle mass area, and right and left paraspinal muscle mass area was performed.
EPTLIF with a minimum 24-month follow-up of 35 levels was included. The complication rate was 6%, and the mean Bridwell's fusion grade was 1.37 (1-2). There was statistically significant improvement at 1 week, 3 months, and 2 years in VAS (4.11±1.23, 4.94±1.30, and 5.46±1.29) and in ODI (40.34±10.06, 46.69±9.14, and 49.63±8.68), respectively (p <0.05). Successful operation rate with excellent and good MacNab's criteria at 2 years was 97%. There was an increment of statistically significant bilateral psoas muscle cross-sectional area, right side (70.03±149.1 mm²) and left side (67.59±113.2 mm²) (p <0.05).
Uniportal EPTLIF achieved good fusion and improved clinical outcomes with favorable paraspinal musculature bulk at the 2-year follow-up.
回顾性队列研究。
对采用单通道全内镜经椎间孔腰椎椎间融合术（EPTLIF）的患者在术后2年时的椎旁肌横截面积及临床结果进行评估。
关于疗效、安全性及生理变化的短期随访研究有限，且缺乏2年随访的研究。目前尚无关于接受单通道EPTLIF患者椎旁肌横截面积变化的研究。
我们对接受EPTLIF且随访至少24个月的患者进行评估。在术前、术后1周、术后3个月及最终随访时测量视觉模拟量表（VAS）和Oswestry功能障碍指数（ODI）等临床参数。术前及术后1年进行磁共振成像测量术前及术后的Kjaer分级、左右腰大肌质量面积以及左右椎旁肌质量面积。
纳入了35个节段、随访至少24个月的EPTLIF病例。并发症发生率为6%，平均Bridwell融合分级为1.37（1 - 2级）。VAS评分在术后1周、3个月及2年时分别为（4.11±1.23、4.94±1.30及5.46±1.29），ODI指数分别为（40.34±10.06、46.69±9.14及49.63±8.68），均有统计学意义的改善（p <0.05）。2年时根据MacNab标准评定的优良手术成功率为97%。双侧腰大肌横截面积有统计学意义的增加，右侧为（70.03±149.1 mm²），左侧为（67.59±113.2 mm²）（p <0.05）。
在2年随访时，单通道EPTLIF实现了良好的融合，改善了临床结果，且椎旁肌肉组织体积良好。
