Department of Orthopaedic Surgery, Show Chwan Memorial Hospital, No. 542, Sec 1, Chung-Shan Rd., Changhua, 500, Taiwan.
PhD Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan.
J Orthop Surg Res. 2024 May 9;19(1):286. doi: 10.1186/s13018-024-04764-2.
This study aimed to compare surgical outcomes, clinical outcomes, and complications between minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) and midline lumbar interbody fusion (MIDLIF) in patients with spondylolisthesis.
This study retrospectively compared the patients who underwent MIS TLIF (n = 37) or MIDLIF (n = 50) for spinal spondylolisthesis. Data of surgical outcomes (postoperative one-year fusion rate and time to bony fusion), clinical outcomes (visual analog scale [VAS] for pain and Oswestry Disability Index [ODI] for spine function), and complications were collected and analyzed.
There was more 2-level fusion in MIDLIF (46% vs. 24.3%, p = 0.038). The MIS TLIF and MIDLIF groups had similar one-year fusion rate and time to fusion. The MIDLIF group had significantly lower VAS at postoperative 3-months (2.2 vs. 3.1, p = 0.002) and postoperative 1-year (1.1 vs. 2.1, p = < 0.001). ODI was not significantly different. The operation time was shorter in MIDLIF (166.1 min vs. 196.2 min, p = 0.014). The facet joint violation is higher in MIS TLIF (21.6% vs. 2%, p = 0.009). The other complications were not significantly different including rate of implant removal, revision, and adjacent segment disease.
In this study, postoperative VAS, operation time, and the rate of facet joint violation were significantly higher in the MIS TLIF group. Comparable outcomes were observed between MIDLIF and MIS TLIF in terms of fusion rate, time to fusion, and postoperative ODI score.
本研究旨在比较微创经椎间孔腰椎体间融合术（MIS TLIF）与正中入路腰椎体间融合术（MIDLIF）治疗腰椎滑脱症的手术结果、临床结果和并发症。
本研究回顾性比较了接受 MIS TLIF（n=37）或 MIDLIF（n=50）治疗的腰椎滑脱症患者。收集并分析了手术结果（术后一年融合率和骨融合时间）、临床结果（疼痛视觉模拟评分[VAS]和脊柱功能 Oswestry 残疾指数[ODI]）和并发症的数据。
MIDLIF 组有更多的 2 级融合（46% vs. 24.3%，p=0.038）。MIS TLIF 和 MIDLIF 组的一年融合率和融合时间相似。MIDLIF 组术后 3 个月（2.2 对 3.1，p=0.002）和术后 1 年（1.1 对 2.1，p<0.001）的 VAS 显著降低。ODI 无显著差异。MIDLIF 的手术时间更短（166.1 分钟对 196.2 分钟，p=0.014）。MIS TLIF 的关节突关节侵犯发生率更高（21.6%对 2%，p=0.009）。其他并发症的发生率无显著差异，包括内植物取出率、翻修率和相邻节段疾病。
在这项研究中，MIS TLIF 组术后 VAS、手术时间和关节突关节侵犯率显著升高。MIDLIF 和 MIS TLIF 在融合率、融合时间和术后 ODI 评分方面具有相似的结果。
