Department Surgery, Orthopaedic Division, Ministry of National Guard-Health Affairs, Jeddah 22384, Saudi Arabia.
King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia.
Medicina (Kaunas). 2023 Mar 16;59(3):585. doi: 10.3390/medicina59030585.
: Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS-TLIF) has been investigated and shown excellent short- and long-term outcomes. In this paper, we describe a new MIS-TLIF technique and pedicle screw insertion using a marker screw as a guidance method. Moreover, we report perioperative, postoperative, and patient-related outcomes. In addition, this paper outlines major differences in radiation exposure, cost effectiveness and accuracy of Marker Screw Minimally Invasive Transforaminal Interbody Fusion (MS-MIS TLIF) compared to other techniques. We report our technique to share our knowledge and experience with the aim of achieving a better MIS-TLIF that would help both surgeons and patients. : A prospective case series was conducted between October 2018 and February 2021. Patients undergoing MS-MIS TLIF with marker screws were consecutively included. The surgery did not exceed two levels. The patients' medical records were reviewed, and the included patients were asked to complete two outcome-questionnaires before surgery and at the six-month visit. The surgical technique is described in this paper. : A total of 37 patients were recruited. The mean age was 57.35 ± 12.8 years, and more than half of the patients were females. The most common indications for surgery were degenerative disc disease and spondylolisthesis, with the typical level at L4-5. The operative time was 3.02 ± 0.83 h, while the estimated blood loss was 127.7 ± 71.1 mL. The average time for ambulation and hospitalization was 1 ± 1.1 and 2.84 ± 1.4 days, respectively. The patients described significant improvement in both questionnaires. No screw-related complications or screw revisions were needed up to two years of follow-up. : The use of marker screws for pedicle screw placement through a minimally invasive fashion is shown to be a promising technique that can overcome many drawbacks, including cost, operative time, and radiation exposure. Performing MS-MIS TLIF can achieve a 360- degree fusion compared to percutaneous MIS-TLIF.
经皮微创经椎间孔腰椎体间融合术（MIS-TLIF）已被广泛研究并证实具有良好的短期和长期效果。本文介绍了一种新的 MIS-TLIF 技术和使用标记螺钉作为引导方法的椎弓根螺钉置入技术。此外，我们还报告了围手术期、术后和患者相关的结果。此外，本文还概述了与其他技术相比，标记螺钉微创经椎间孔腰椎体间融合术（MS-MIS TLIF）在辐射暴露、成本效益和准确性方面的主要差异。我们报告我们的技术是为了分享我们的知识和经验，旨在实现更好的 MIS-TLIF，这将有助于外科医生和患者。
本研究为前瞻性病例系列研究，时间为 2018 年 10 月至 2021 年 2 月。连续纳入接受 MS-MIS TLIF 联合标记螺钉的患者。手术不超过两个节段。回顾患者病历，在术前和术后 6 个月要求纳入患者完成两项结果调查问卷。本文描述了手术技术。
共纳入 37 例患者，平均年龄 57.35±12.8 岁，女性患者多于男性。最常见的手术指征为退行性椎间盘疾病和腰椎滑脱，典型病变位于 L4-5 节段。手术时间为 3.02±0.83 小时，估计失血量为 127.7±71.1 毫升。平均下床和住院时间分别为 1±1.1 天和 2.84±1.4 天。患者在两项问卷中均描述了显著的改善。在随访 2 年期间，无需螺钉相关并发症或螺钉修正。
通过微创方式使用标记螺钉进行椎弓根螺钉放置显示出是一种很有前途的技术，可以克服许多缺点，包括成本、手术时间和辐射暴露。与经皮 MIS-TLIF 相比，进行 MS-MIS TLIF 可以实现 360 度融合。
