Song Xin, Ren Zhinan, Cao Shuyan, Zhou Weiwei, Hao Yingjie
Department of Orthopedic, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Department of Orthopedic, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
World Neurosurg. 2023 May;173:e371-e377. doi: 10.1016/j.wneu.2023.02.059. Epub 2023 Feb 15.
The study purpose was to compare unilateral biportal endoscopic lumbar interbody fusion (ULIF) with minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for the treatment of lumbar degenerative diseases in terms of surgical trauma and short-to medium-term postoperative results.
Forty-nine patients with lumbar degenerative diseases (25 underwent ULIF, 24 underwent MIS-TLIF) who were treated between May 2019 and October 2021, were included in this retrospective analysis. We compared the 2 groups' blood loss, serum C-reactive protein (CRP), visual analog scale (VAS) scores for low back and leg pain, and the Oswestry Disability Index (ODI) score and slip percentage (SP). The modified Macnab score was obtained at the last follow-up.
On the postoperative day, the CRP levels (P < 0.05) were considerably lower in the ULIF group than those in the MIS-TLIF group. In addition, the ULIF group had significantly decreased intraoperative blood loss (P = 0.00) and postoperative blood loss (P = 0.00). After surgery, there was significant improvement in both groups in the VAS scores for low back and leg pain and in the ODI scores (P < 0.05). Two weeks after surgery, the ODI and VAS scores for low back pain of the ULIF group were considerably lower than those of the MIS-TLIF group (P < 0.05). The excellent and good rates of the Macnab criteria between the 2 groups were not significantly different at the last follow-up (P = 0.95).
The ULIF technique can effectively treat short-segment lumbar degenerative diseases and is a feasible alternative to the traditional minimally invasive surgery.
本研究旨在比较单侧双孔内镜下腰椎椎间融合术(ULIF)与微创经椎间孔腰椎椎间融合术(MIS-TLIF)在治疗腰椎退行性疾病时的手术创伤及术后中短期疗效。
纳入2019年5月至2021年10月期间接受治疗的49例腰椎退行性疾病患者(25例行ULIF,24例行MIS-TLIF)进行回顾性分析。比较两组的失血量、血清C反应蛋白(CRP)、腰腿痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)评分及滑脱百分比(SP)。末次随访时采用改良Macnab评分。
术后第1天,ULIF组CRP水平显著低于MIS-TLIF组(P<0.05)。此外,ULIF组术中失血量(P=0.00)和术后失血量(P=0.00)均显著减少。术后,两组腰腿痛VAS评分及ODI评分均有显著改善(P<0.05)。术后2周,ULIF组ODI及腰背痛VAS评分显著低于MIS-TLIF组(P<0.05)。末次随访时,两组Macnab标准优良率差异无统计学意义(P=0.95)。
ULIF技术可有效治疗短节段腰椎退行性疾病,是传统微创手术的可行替代方案。