Nguyen Long Hoang, Manh Do Hung, Pham Phong Hong, Bui Hoang Minh, Duong Anh Tung, Nguyen Khanh Manh, Dinh Son Ngoc, Doan Ha Thi-Ngoc, Nguyen Tien Le-Bao
Department of Spinal Surgery Vietduc University Hospital.
University of Medicine and Pharmacy, Vietnam National University.
Ann Med Surg (Lond). 2023 May 8;85(6):2518-2521. doi: 10.1097/MS9.0000000000000746. eCollection 2023 Jun.
Minimally invasive transforaminal lumbar interbody fusion has proven effectiveness in treating spondylolisthesis, but there were few reports applying the technique from scarce resourcing developing countries. In this study, the authors report the results and share our experience of minimally invasive spinal transforaminal lumbar interbody fusion in spondylolisthesis treatment in Vietnamese patients.
In this study, the authors enroled 92 patients diagnosed with single-level, grade I or grade II lumbar spondylolisthesis from January 2019 to October 2022.
The median age in our study was 47.79±12.61 (range 15-75), the male/female ratio was 1/2.3. The mean disease duration was 28.57 months. Conventional X-ray images showed that there were 74 patients (80.43%) with spondylolisthesis grade I, 18 patients (19.57%) with grade II. Spondylolisthesis occured mainly in L4-L5 with 53 patients (57.61%). The isthmic sign was recorded in 16 patients (31.4%). The mean blood loss was 149.46 ml. Patients walked on average of 3.22 days after surgery. VAS score reduced significantly in both back and leg. Spinal function improved significantly with a preoperative Owestry Disability Index of 48.18% decrease to 15.18% 12 months after surgery. The surgical results were good and excellent at 95.00% after 12 months of surgery according to Macnab scale. The fusion rate reached 97.50%.
The results of this Macnab's classification study show that minimally invasive spinal transforaminal lumbar interbody fusion is an effective treatment for spondylolisthesis with less pain, less blood loss after surgery, and high fusion rate.
微创经椎间孔腰椎椎间融合术已被证明在治疗腰椎滑脱方面有效，但来自资源匮乏的发展中国家应用该技术的报道很少。在本研究中，作者报告了在越南患者中应用微创脊柱经椎间孔腰椎椎间融合术治疗腰椎滑脱的结果并分享我们的经验。
在本研究中，作者纳入了2019年1月至2022年10月期间诊断为单节段、I级或II级腰椎滑脱的92例患者。
本研究的中位年龄为47.79±12.61岁（范围15 - 75岁），男女比例为1/2.3。平均病程为28.57个月。传统X线图像显示，I级腰椎滑脱患者74例（80.43%），II级患者18例（19.57%）。腰椎滑脱主要发生在L4 - L5节段，共53例（57.61%）。峡部裂征记录于16例患者（31.4%）。平均失血量为149.46毫升。患者术后平均3.22天即可行走。腰背部和腿部的视觉模拟评分（VAS）均显著降低。脊柱功能显著改善，术前Oswestry功能障碍指数为48.18%，术后12个月降至15.18%。根据Macnab标准，术后12个月手术优良率达95.00%。融合率达到97.50%。
本Macnab分类研究结果表明，微创脊柱经椎间孔腰椎椎间融合术是治疗腰椎滑脱的有效方法，术后疼痛轻、失血少、融合率高。
