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| GAO Jiang,MA Liang,WANG Yi.A comparison of the clinical efficacies of lumbar interbody fusion via percutaneous endoscopic interlaminar approach and minimally invasive transforaminal approach in the treatment of grade Ⅰ and Ⅱ lumbar spondylolisthesis[J].Chinese Journal of Spine and Spinal Cord,2023,(11):1003-1010. |
| A comparison of the clinical efficacies of lumbar interbody fusion via percutaneous endoscopic interlaminar approach and minimally invasive transforaminal approach in the treatment of grade Ⅰ and Ⅱ lumbar spondylolisthesis |
| Received:June 27, 2023 Revised:October 12, 2023 |
| English Keywords:Lumbar spondylolisthesis Percutaneous endoscopic posterior lumbar interbody fusion Minimally invasive transforaminal lumbar interbody fusion Efficacy |
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| English Abstract: |
| 【Abstract】 Objectives: To compare the clinical efficacies of percutaneous endoscopic posterior lumbar interbody fusion(PE-PLIF) and minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF) in the treatment of grade Ⅰ and Ⅱ lumbar spondylolisthesis. Methods: The clinical data of 70 patients with single level lumbar spondylolisthesis treated with PE-PLIF or MIS-TLIF in the Department of Minimally Invasive Spinal Surgery of the Sixth Affiliated Hospital of Xinjiang Medical University between January 2020 and January 2022 were analyzed retrospectively, including 33 males and 37 females, aged 59.6±11.0 years old. According to different surgical methods, the patients were divided into PE-PLIF group of 36 cases and MIS-TLIF group of 34 cases. The operative time, intraoperative blood loss, postoperative 3d serum indexes such as creatine kinase(CK), C-reactive protein(CRP) and interleukin-6(IL-6) were collected and compared between groups, as well as low back and leg pain visual analogue scale(VAS) and Oswestry disability index(ODI) before operation, at 1 week, and 3 and 6 months, and 1 year after operation. 3D reconstruction CT was used to evaluate interbody fusion according to the Bridwell′s fusion grading system at 2 years after operation, and postoperative complications were also documented. Results: PE-PLIF group was significantly less than MIS-TLIF group in intraoperative blood loss(91.6±45.8mL vs 195.5±126.3mL, P=0.000), longer in operative time(227.5±58.0min vs 194.1±55.2min, P=0.016), and lower postoperative 3d CK, CRP, IL-6(P<0.05). The VAS score and ODI in both groups were significantly improved compared with those before operation, while the VAS score in PE-PLIF group improved more obvious than that in MIS-TLIF group at one week after operation(P=0.02), and no statistically significant difference was there in the VAS scores between groups at other time points(P>0.05). PE-PLIF group wasn′t significantly different from MIS-TLIF group in the fusion conditions at 2 years after operation(86% vs 94%, P=0.430); There were no serious complications requiring revision surgery in both groups. Conclusions: PE-PLIF is less traumatic and relieves low back pain better at early postoperation than MIS-TLIF in the treatment of grade Ⅰ and grade Ⅱ lumbar spondylolisthesis, while PE-PLIF isn′t significantly differ from MIS-TLIF in mid-to-long term clinical efficacy. |
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