Peng Yu-Jian, Zhao Tian-Bu, Dai Jun, Wang Qian-Liang, Zhang Qian-Zhong-Yi, Cao Jun-Yin, Liu Xiao-Feng
Department of Orthopedic Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Department of Emergency Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Front Surg. 2022 Jul 29;9:926329. doi: 10.3389/fsurg.2022.926329. eCollection 2022.
Here, we sought to determine the safety and feasibility of three-dimensional exoscope (3D EX). We compared data on surgery, complications, postoperative drainage, hematology, and clinical outcomes in the group that underwent transforaminal lumbar interbody fusion (TLIF) using an operative microscope (OM) relative to those treated using 3D EX.
We retrospectively reviewed records on 74 patients who underwent one- or two-level TLIF from August 2019 to October 2020. Repeated measures analysis of variance was used to compare pre- and post-operative visual analogue scale (VAS) scores and oswestry disability index (ODI). We used analysis of covariance to compare pre- and post-operative erythrocyte count (RBC), hemoglobin (Hb), and hematocrit (Hct). Independent sample t-tests was used to compare postoperative drainage volume, total blood loss (TBL), visible blood loss (VBL) and hidden blood loss (HBL).
There were no significant differences in VAS and ODI scores between the two groups at all time points (all > 0.05). RBC and HBL did not differ significantly between the two groups (all > 0.05). There were significant differences in postoperative drainage volume,TBL, Hb, and Hct values when using 3D EX relative to OM in two-level TLIF (all < 0.05), but not for one-level TLIF (all > 0.05). The two groups differed significantly with regards to VBL when used for one- or two-level TLIF (all < 0.05).
Our data show that 3D EX is a suitable alternative to OM in TLIF. Relative to OM, 3D EX has important strengths in reducing perioperative bleeding in two-level TLIF.
在此，我们试图确定三维外视镜（3D EX）的安全性和可行性。我们比较了使用手术显微镜（OM）进行经椎间孔腰椎椎间融合术（TLIF）的组与使用3D EX治疗的组在手术、并发症、术后引流、血液学和临床结果方面的数据。
我们回顾性分析了2019年8月至2020年10月期间接受单节段或双节段TLIF的74例患者的记录。采用重复测量方差分析比较术前和术后视觉模拟量表（VAS）评分和Oswestry功能障碍指数（ODI）。我们使用协方差分析比较术前和术后红细胞计数（RBC）、血红蛋白（Hb）和血细胞比容（Hct）。采用独立样本t检验比较术后引流量、总失血量（TBL）、可见失血量（VBL）和隐性失血量（HBL）。
两组在所有时间点的VAS和ODI评分均无显著差异（均>0.05）。两组之间的RBC和HBL无显著差异（均>0.05）。在双节段TLIF中，使用3D EX相对于OM时，术后引流量、TBL、Hb和Hct值存在显著差异（均<0.05），但在单节段TLIF中无显著差异（均>0.05）。在用于单节段或双节段TLIF时，两组在VBL方面存在显著差异（均<0.05）。
我们的数据表明，在TLIF中，3D EX是OM的合适替代方案。相对于OM，3D EX在减少双节段TLIF围手术期出血方面具有重要优势。
