Author:
Chen Hao,Zheng Goudi,Bian Zhenyu,Hou Changju,Li Maoqiang,Zhang Zhen,Zhu Liulong,Wang Xuepeng
Abstract
Abstract
Background
Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and endoscopic lumbar interbody fusion (Endo-LIF) are both minimally invasive interbody fusion procedures for lumbar degenerative diseases. In this study, we attempted to compare the clinical efficacy and postoperative outcomes of MIS-TLIF and Endo-LIF for lumbar degenerative diseases.
Methods
The study cohort comprised 99 patients with lumbar degenerative diseases treated by MIS-TLIF or Endo-LIF from January 2019 to July 2021. The clinical outcomes (visual analogue scale (VAS), Oswestry disability index (ODI), and MacNab criteria) preoperatively, 1 month postoperatively, 3 months postoperatively, and 1 year postoperatively were compared between the two groups.
Results
There were no significant differences between the two groups in sex, age, disease duration, affected spine segment, and complications (P > 0.05). The operation time was significantly longer in the Endo-LIF group than the MIS-TLIF group (155.25 ± 12.57 vs. 123.14 ± 14.50 min; P < 0.05). However, the Endo-LIF group had a significantly smaller blood loss volume (61.79 ± 10.09 vs. 259.97 ± 14.63 ml) and shorter hospital stay (5.46 ± 1.11 vs. 7.06 ± 1.42 days) than the MIS-TLIF group. In both groups, the ODI and VAS scores for lower back pain and leg pain were significantly lower at each postoperative timepoint than preoperatively (P < 0.05). Although there were no significant differences between the two groups in the ODI and VAS scores for lower back pain and leg pain (P > 0.05), the VAS for lower back pain was lower in the Endo-LIF group than the MIS-TLIF group at each postoperative timepoint. The MacNab criteria showed that the improvement rate was 92.2% in the MIS-TLIF group and 91.7% in the Endo-LIF group, with no significant difference between the two groups (P > 0.05).
Conclusions
There were no significant differences in short-term surgical outcomes between the MIS-TLIF and Endo-LIF groups. Compared with the MIS-TLIF group, the Endo-LIF group incurred less damage to surrounding tissues, experienced less intraoperative blood loss, and had less lower back pain, which is more conducive to recovery.
Funder
Zhejiang Provincial Public Welfare Research Project
Zhejiang Province Medical and Health Technology Project
Publisher
Springer Science and Business Media LLC
Subject
Orthopedics and Sports Medicine,Surgery
Reference24 articles.
1. Mobbs RJ, Phan K, Malham G, et al. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF. Spine Surg. 2015;1(1):2–18.
2. Jin YM, Chen Q, Chen CY, et al. Clinical research and technique note of TLIF by Wiltse approach for the treatment of degenerative lumbar. Orthop Surg. 2021;13(5):1628–38.
3. Mu XP, Yu CQ, Wang CL, et al. Comparison of extreme lateral approach with posterior approach in the treatment of lumbar degenerative diseases: a meta-analysis of clinical and imaging findings. Surgeon. 2021;19(5):268–78.
4. Liu HN, Li JQ, Sun YP, et al. A comparative study of a new retractor-assisted WILTSE TLIF, MIS-TLIF, and traditional PLIF for treatment of single-level lumbar degenerative diseases. Orthop Surg. 2022;14(7):1317–30.
5. Foley KT, Holly LT, Schwender JD. Minimally invasive lumbar fusion. Spine. 2003;28:S26–35.