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| XIAO Bo,MAO Keya,WANG Yan.The learning curve of minimally invasive transforaminal lumbar interbody fusion hybrid using pedical screws and translamina facet screw system[J].Chinese Journal of Spine and Spinal Cord,2013,(3):209-214. |
| The learning curve of minimally invasive transforaminal lumbar interbody fusion hybrid using pedical screws and translamina facet screw system |
| Received:November 04, 2012 Revised:December 09, 2012 |
| English Keywords:Transforaminal lumbar interbody fusion Translamina facet screw Minimally invasive Learning curve |
| Fund:军队十二五课题（编号：CWS11J110），国家自然科学基金（编号：50830102），国家863计划（编号：2009AA02Z405） |
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| English Abstract: |
| 【Abstract】 Objectives: To investigate the learning curve of minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF) hybrid using pedical screws and translamina facet screw. Methods: A retrospective analysis was performed on 48 patients who underwent MIS-TLIF using pedical screws and a translamina facet screw complex in our hospital from October 2009 to July 2011. They were divided chronologically into 4 groups with 12 cases in each group. The operation time, intra-operative blood loss, the operative complications, the instrument failure rate, the fusion rate and the clinical outcomes were recorded and compared between every 2 groups. Results: The mean follow-up was 16.3 months, and the average operation time was (139.17±18.32)min, (115.00±14.62)min, (110.83±11.04)min, and (110.83±18.32)min for group A-D respectively. The average intra-operative blood loss was (140.83±33.76)ml, (83.33±28.39)ml, (69.17±25.03)ml, and (64.17±25.75)ml for group A-D respectively. Group B, C, D had less operation time and blood loss than group A(P＜0.05), while no statistical difference existed among group B, C, D. Complications were noted in 3 patients, which included 2 dura tearing and 1 neurological injury in group A, 1 dura tearing in group B. The instrument failure was noted in 2 patients in group A, 1 in group B. No case of nonunion was found, there was no statistical difference among 4 groups(P＞0.05). The visual analogue scales(VAS) for back and leg pain of each group before operation were as follows: A, (4.3±3.2)/(5.5±3.1), B, (4.5±3.8)/(6.8±3.7); C, (4.1±3.5)/(5.7±3.6), D, (4.8±3.1)/(6.3±4.1); 1 year after operation were as follows: A, (1.3±1.1)/(0.4±0.3); B, (1.4±0.9)/(0.3±0.2); C, (1.2±0.8)/(0.3±0.4); D, (1.4±1.0)/(0.2±0.2). The Oswestry disability index(ODI) scorces of each group before operation were as follows: A, (40.2±8.1)％; B, (45.4±9.7)％; C, (43.2±7.9)％; D, (39.2±8.4)％; 1 year after operation were as follows: A, (15.2±8.7)%; B, (14.8±9.4)%; C, (13.9±8.6)%; D, (14.1±7.9)%, which all showed significant improvement compared with those of preoperation(P＜0.05), but no statistical difference existed among 4 groups(P＞0.05). Conclusions: The MIS-TLIF using pedical screws and a translamina facet screw complex working under straight view, that can significantly lower the the learning curve, improve fusion rate and clinical outcome. |
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