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| YAN Guoliang,JI Zhengang,GAO Haoran.Outcomes of minimally invasive transforaminal lumbar interbody fusion via Quadrant retractor versus conventional posterior open surgery for degenerative lumbar spine disease[J].Chinese Journal of Spine and Spinal Cord,2013,(3):244-250. |
| Outcomes of minimally invasive transforaminal lumbar interbody fusion via Quadrant retractor versus conventional posterior open surgery for degenerative lumbar spine disease |
| Received:November 27, 2012 Revised:January 18, 2013 |
| English Keywords:Lumbar fusion Minimally invasive surgery Open surgery Clinical outcomes |
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| English Abstract: |
| 【Abstract】 Objectives: To compare clinical outcomes of minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF group) via MAST Quadrant retractor vs conventional posterior open surgery(open group) for degenerative lumbar spine disease. Methods: From March 2008 to June 2010, 80 patients with single-level lumbar degenerative disease and failed with conservative treatment were enrolled in this study. All cases were divided into two groups randomly, with 40 patients in each group. There was no significant difference in age, gender, body weight, clinical diagnosis or the segment between the two groups(P>0.05). Minimally invasive transforaminal lumbar interbody fusion via MAST Quadrant retractor or the conventional posterior open surgery was performed randomly. The operation time, blood loss, postoperative drainage, hospital stay, creatine phosphokinase(CPK) in serum, MRI-T2 relaxation time, visual analogue scores(VAS) for back and leg pain, Oswestry disability index(ODI), and fusion rate by 24-36 months follow-up(mean time, 29 months) between two groups were compared. Results: The MIS-TLIF group had similar operation time to the open surgery group(141.0±27.3min vs 139.5±33.7min, P>0.05). Intraoperative blood loss, postoperative drainage in MIS-TLIF group was 268.0±122.2ml and 25.6±32.4ml, which was significantly less than 370.0±147.1ml and 277.8±167.4ml of the open group, respectively(P<0.05); postoperative hospitalization time of MIS-TLIF group was shorter than that of open group(7.3±3.2d vs 9.5±2.7d, P<0.05). The VAS and ODI were lower at 1 and 24 months postoperatively than preoperative ones in both groups(P<0.05). At 1 month, the MIS-TLIF group had lower VAS score than open surgery group(P<0.05), while no significant differences with respect to VAS for back and leg pain at 24-month and ODI at 1 and 24 months were noted between the two groups(P>0.05). The CPK levels were significantly higher at 1, 3, 5 days after surgery(P<0.05), and peaked at 1 day after surgery, meanwhile, which were significantly lower in the MIS-TLIF group than the open group at 1, 3 days after surgery(P<0.05). The MRI-T2 relaxation time of the multifidus muscle was significantly better in the MIS-TLIF group than the open surgery group at 3 months after surgery(P<0.05). Radiological analysis showed similar fusion rate at 6 and 24 months after surgery(P>0.05). Conclusions: Minimally invasive transforaminal lumbar interbody fusion via MAST Quadrant retractor surgery and conventional posterior open surgery both can achieve a good short-term efficiency, but the former surgery had less soft tissue intervention, and conducive to early functional recovery. |
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