Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Yanchang Road 301, Shanghai, 200072, People's Republic of China.
Department of Nursing, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Yanchang Road 301, Shanghai, 200072, People's Republic of China.
Eur Spine J. 2024 Mar;33(3):1120-1128. doi: 10.1007/s00586-023-08096-3. Epub 2024 Feb 13.
This research aims to compare the clinical outcomes of VBE-TLIF and MIS-TLIF for the treatment of patients with single-level degenerative lumbar diseases.
Ninety patients were enrolled in this study. The estimated blood loss, operation time, postoperative hospitalization days, time to functional exercise, amount of surgical drain and inflammatory index were recorded. The visual analog scale, Oswestry dysfunction index and modified MacNab criteria were used to assessed the patient's back and leg pain, functional status and clinical satisfaction rates.
The average operation time of the VBE-TLIF group was longer than that of the MIS-TLIF group. The time for functional exercise, length of hospital stay, estimated blood loss and amount of surgical drain in the VBE-TLIF group were relative shorter than those in the MIS-TLIF group. Additionally, the levels of CRP, neutrophil, IL-6 and CPK in the VBE-TLIF group were significantly lower than those in the MIS-TLIF group at postoperative days 1 and 3, respectively (P < 0.001). Patients undergoing VBE-TLIF had significantly lower back VAS scores than those in the MIS-TLIF group on postoperative days 1 and 3 (P < 0.001). No significant differences were found in the clinical satisfaction rates (95.83 vs. 95.24%, P = 0.458) or interbody fusion rate (97.92 vs. 95.24%, P = 0.730) between these two surgical procedures.
Both VBE-TLIF and MIS-TLIF are safe and effective surgical procedures for patients with lumbar diseases, but VBE-TLIF technique is a preferred surgical procedure with merits of reduced surgical trauma and quicker recovery.
本研究旨在比较经皮椎间孔镜下腰椎间融合术（VBE-TLIF）与微创经椎间孔腰椎间融合术（MIS-TLIF）治疗单节段退变性腰椎疾病的临床疗效。
本研究纳入了 90 例患者。记录了两组患者的出血量、手术时间、术后住院天数、开始功能锻炼的时间、引流管引流量和炎症指标。采用视觉模拟评分法（VAS）、Oswestry 功能障碍指数（ODI）和改良 MacNab 标准评估患者腰背疼痛、功能状态和临床满意度。
VBE-TLIF 组的平均手术时间长于 MIS-TLIF 组，而 VBE-TLIF 组的功能锻炼时间、住院时间、出血量和引流管引流量均短于 MIS-TLIF 组。此外，VBE-TLIF 组术后第 1 天和第 3 天的 CRP、中性粒细胞、IL-6 和 CPK 水平明显低于 MIS-TLIF 组（P<0.001）。术后第 1 天和第 3 天，VBE-TLIF 组的腰背 VAS 评分明显低于 MIS-TLIF 组（P<0.001）。两种手术的临床满意度（95.83%比 95.24%，P=0.458）和椎间融合率（97.92%比 95.24%，P=0.730）差异均无统计学意义。
VBE-TLIF 与 MIS-TLIF 治疗腰椎疾病均安全有效，但 VBE-TLIF 技术创伤更小，恢复更快，是一种更优的手术选择。
