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斯洛伐克微创脊柱治疗的最新进展及其与开放手术治疗腰椎退行性疾病的比较。

Latest Developments in Minimally Invasive Spinal Treatment in Slovakia and Its Comparison with an Open Approach for the Treatment of Lumbar Degenerative Diseases.

作者信息

Potašová Marina, Filipp Peter, Rusnák Róbert, Moraučíková Eva, Repová Katarína, Kutiš Peter

机构信息

Department of Physiotherapy, Faculty of Health, Catholic University in Ruzomberok, 034 01 Ruzomberok, Slovakia.

Neurosurgery Clinic, Central Military Hospital SNP in Ruzomberok, 034 01 Ruzomberok, Slovakia.

出版信息

J Clin Med. 2023 Jul 18;12(14):4755. doi: 10.3390/jcm12144755.

Abstract

The study describes the benefits of MIS-TLIF (minimally invasive transforaminal lumbar interbody fusion) and compares them with OTLIF (open transforaminal lumbar interbody fusion). It compares blood loss, length of hospitalization stays (LOS), operation time, and return of the patient to the environment. A total of 250 adults (109 males and 141 females), mean age 59.5 ± 12.6, who underwent MIS-TLIF in the Neurosurgery Clinic (NSC) Ruzomberok, Slovakia, because of lumbar degenerative diseases (LDD), participated in this retrospective study. Data were obtained from the patients' medical records and from the standardized Oswestry Disability Index (ODI) index questionnaire. To compare ODI in our study sample, we used the Student's Paired Sample Test. To compare the MIS-TLIF and OTLIF approaches, a meta-analysis was conducted. Confidence intervals were 95% CI. The test of homogeneity (Chi-square (Q)) and the degree of heterogeneity (I test) among the included studies were used. Statistical analyses were two-sided (α = 0.05). All monitored parameters were significantly better in MIS-TLIF group: blood loss ( < 0.001), operation time ( < 0.001), and ODI changes ( < 0.001). LOS ( < 0.042) were close to the significance level. ODI in the study sample decreased by 33.44% points after MIS-TLIF, and it significantly increased as well ( < 0.001). The percentage of patients who were satisfied with the surgery they underwent was 84.8%. The study confirmed that the MIS-TLIF method is in general gentler for the patient and allows the faster regeneration of patient's health status compared to OTLIF.

摘要

该研究描述了微创经椎间孔腰椎椎间融合术(MIS-TLIF)的益处,并将其与开放经椎间孔腰椎椎间融合术(OTLIF)进行比较。研究比较了失血量、住院时间(LOS)、手术时间以及患者恢复日常活动的情况。共有250名成年人(109名男性和141名女性)参与了这项回顾性研究,他们因腰椎退行性疾病(LDD)在斯洛伐克鲁佐姆贝罗克神经外科诊所(NSC)接受了MIS-TLIF手术,平均年龄为59.5±12.6岁。数据来自患者的病历和标准化的奥斯威斯利功能障碍指数(ODI)问卷。为了比较我们研究样本中的ODI,我们使用了学生配对样本检验。为了比较MIS-TLIF和OTLIF方法,进行了荟萃分析。置信区间为95%CI。使用了纳入研究之间的同质性检验(卡方检验(Q))和异质性程度检验(I检验)。统计分析为双侧检验(α=0.05)。在MIS-TLIF组中,所有监测参数均显著更好:失血量(<0.001)、手术时间(<0.001)和ODI变化(<0.001)。住院时间(<0.042)接近显著水平。MIS-TLIF术后研究样本中的ODI下降了33.44个百分点,且也显著增加(<0.001)。对所接受手术感到满意的患者比例为84.8%。该研究证实,与OTLIF相比,MIS-TLIF方法总体上对患者的创伤更小,并能使患者的健康状况更快恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/348f/10381332/545078cceebd/jcm-12-04755-g001.jpg

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