Comparison of minimally invasive transforaminal lumbar interbody fusion (Mis-TLIF) with bilateral decompression via unilateral approach and open-TLIF with bilateral decompression for degenerative lumbar diseases: a retrospective cohort study

作者全名："Zhu, Fengzhao; Jia, Dongqing; Zhang, Yaqing; Feng, Chencheng; Ning, Ya; Leng, Xue; Zhou, Yue; Li, Changqing; Huang, Bo"

作者地址："[Zhu, Fengzhao; Zhang, Yaqing; Feng, Chencheng; Ning, Ya; Leng, Xue; Zhou, Yue; Li, Changqing; Huang, Bo] Army Med Univ, Xinqiao Hosp, Dept Orthoped, Chongqing, Peoples R China; [Jia, Dongqing] Chongqing Med Univ, Univ Town Hosp, Dept Blood Transfus, Chongqing, Peoples R China"

通信作者："Huang, B (通讯作者)，Army Med Univ, Xinqiao Hosp, Dept Orthoped, Chongqing, Peoples R China."

来源：JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001174801000001

JCR分区：Q1

影响因子：2.8

年份：2024

卷号：19

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Minimally invasive transforaminal lumbar interbody fusion; Bilateral decompression via unilateral approach; Open-TLIF; Degenerative lumbar diseases; Learning curve

摘要："Objective Presently, no study has compared the clinical outcomes of minimally invasive transforaminal lumbar interbody fusion (Mis-TLIF) with bilateral decompression via the unilateral approach (BDUA) and Open-TLIF with bilateral decompression for degenerative lumbar diseases (DLD). We aimed to compare the clinical outcomes of through Mis-TLIF combined with BDUA and Open-TLIF with bilateral decompression for the treatment of DLD, and reported the learning curve of the procedure of MIS-TLIF with BDUA. Methods We retrospectively analyzed the prospectively collected data of consecutive DLD patients in the two groups from January 2016 to January 2020. Results The operative time (OT) was significantly longer in the Mis-TLIF group (n = 113) than in the Open-TLIF group (n = 135). The postoperative drainage volume (PDV) and length of stay (LOS) were significantly higher in the Open-TLIF group than in the Mis-TLIF group. Additionally, the complication rate was significantly higher in the Open-TLIF group than in the Mis-TLIF group (14.8% vs. 6.2%, P = 0.030), while there was no significant difference in the reoperation and adjacent segment disease rates between the two groups. There were no significant differences in back pain and leg pain Numerical Rating Scale (NRS) scores and Oswestry Disability Index (ODI) between the two groups preoperatively, at discharge, and 2 years postoperatively. Patients in both groups showed significant improvements in NRS scores and ODI scores after surgery. OT was negatively correlated with the number of surgeries performed (P < 0.001, r = -0.43). The learning curve of Mis-TLIF with BDUA was steep, with OT tapered to steady state in 43 cases. Conclusion Compared with Open-TLIF with bilateral decompression, Mis-TLIF with BDUA can achieve equivalent clinical outcomes, lower PDV and LOS, and lower complication rates. Although this procedure took longer, it could be a viable alternative for the treatment of DLD after a steep learning curve."

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