ZHANG Yulei 1 , LI Fuping 2 , XI Xin 2 , ZENG Zhili 2 , MA Bin 2 , XIE Ning 2 , YU Yan 2 , CHENG Liming 2
  • 1. Department of Radiology, Tongji Hospital, Tongji University, Shanghai, 200065, P.R.China;
  • 2. Department of Spine Surgery, Tongji Hospital, Tongji University, Shanghai, 200065, P.R.China;
YU Yan, Email: yuyan_83@hotmail.com
Transforaminal lumbar interbody fusion; open technique; minimally invasive technique; intervertebral height; lordosis; lumbar degenerative disease
10.7507/1002-1892.201910060
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Objective To analyze the restoration of intervertebral height and lordosis of fusion segment after open-transforaminal lumbar interbody fusion (Open-TLIF) and minimally invasive-TLIF (MIS-TLIF).Methods Between January 2013 and February 2016, patients who treated with TLIF due to lumbar degenerative diseases and met the selection criteria were selected as the study objects. Among them, 41 patients were treated with open-TLIF (Open-TLIF group), 34 patients were treated with MIS-TLIF (MIS-TLIF group). There was no significant difference between the two groups (P>0.05) in gender, age, body mass index, disease type, disease duration, pathological segment, and other general data. The intraoperative bleeding volume, hospital stay, visual analogue scale (VAS) score of waist and leg, and Oswestry disability index (ODI) were recorded before and after operation. The anterior disc height (ADH), posterior disc height (ADH), and segmental lordosis (SL) of fusion segment were measured by X-ray film before and at 6 months after operation. The differences of ADH, PDH, and SL between pre- and post-operation were calculated.Results The intraoperative bleeding volume and hospital stay in Open-TLIF group were significantly higher than those in MIS-TLIF group (t=14.619, P=0.000; t=10.021, P=0.000). All incisions healed by first intention without early complications. All patients were followed up 6-24 months (mean, 12.6 months) in Open-TLIF group and 6-24 months (mean, 11.5 months) in MIS-TLIF group. The preoperative VAS scores of waist and leg and ODI of the two groups significantly improved (P<0.05). There was no significant difference in VAS scores and ODI between the two groups before operation and at 2 weeks and 6 months after operation (P>0.05). Imaging examination showed the good intervertebral fusion. There was no significant difference in ADH, PDH, and SL between the two groups before operation and at 6 months after operation (P>0.05). The differences of ADH, PDH, and SL between the two groups were not significant (P>0.05). The ADH, PDH, and SL after operation significantly increased in the two groups (P<0.05).Conclusion Open-TLIF and MIS-TLIF show similar effectiveness and radiological change in the treatment of single lumbar degenerative diseases and the improved intervertebral height and lordosis, but MIS-TLIF can significantly reduce hospital stay and intraoperative blood loss.

Citation： ZHANG Yulei, LI Fuping, XI Xin, ZENG Zhili, MA Bin, XIE Ning, YU Yan, CHENG Liming. Comparison of intervertebral height and lordosis of fusion segment between open- and minimally invasive-transforaminal lumbar interbody fusions. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(4): 422-427. doi: 10.7507/1002-1892.201910060 Copy