Citation: | XU Mingkui, CHEN Meixiong, XU Riming, LIN Yewu, LUO Yuantai, CHEN Yingwei, ZHOU Li. Clinical efficacy of minimally invasive transforaminal lumbar interbody fusion by lower Quadrant channel through the muscle gap approach in treatment of lumbar degenerative disease[J]. Journal of Clinical Medicine in Practice, 2022, 26(11): 94-99. DOI: 10.7619/jcmp.20214699 |
To investigate the clinical efficacy and safety of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) by lower Quadrant channel through the muscle gap approach in treatment of lumbar degenerative diseases.
A total of 56 patients with lumbar degenerative disease were selected as study objects, and 32 patients treated with MIS-TLIF by lower Quadrant channel through the muscle gap approach were included in the minimally invasive group, and 24 patients treated with open transvertebral foraminal lumbar interbody fusion (TLIF) were included in the open group.The operation time, intraoperative blood loss, incision drainage volume, analgesic dosage, ambulation time and postoperative hospital stay of the two groups were observed, and Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate the pain and lumbar function before operation, 1 week, 6 months and 12 months after operation.At 12 months after surgery, the height of the intervertebral space and the Cobb angle of the lumbar coronal surface of the two groups were compared, and the postoperative complications of the two groups were compared.The occurrence of adverse reactions between two groups were compared.
Theblood loss, wound drainage volume, usage of pain medications of the minimally invasive group were less than those of the open group, while the postoperative ambulation time and hospital stay of the minimally invasive group were shorter than those of the open group (P < 0.05).The levels of serum creatine phosphate kinase (CPK) at 1, 3 and 7 d after operation in the two groups were significantly higher than those before operation, and the level of serum CPK in the minimally invasive group was lower than that in the open group (P < 0.05).The VAS scores and ODI at 1 week, 6 months, 12 months after surgery of the two groups were significantly lower than those before operation (P < 0.05).The VAS score and ODI at 1 week and 6 months after operation of the minimally invasive group were lower than those of the open group (P < 0.05).At 12 months after operation, there were significant difference in intervertebral space height and Cobb angle of lumbar coronal plane (P < 0.05).There were 2 cases with complications in minimally invasive group and 3 cases in the open group.They were all cured after conservative treatment with dressing changes.
MIS-TLIF by lower Quadrant channel through the muscle gap approach in treatment of lumbar degenerative diseases has the advantages of less trauma, higher safety, faster postoperative recovery, favorable prognosis, so it is worthy of clinical promotion.
[1] |
吴翔, 徐晓华, 杨志华. 后路椎体间融合术与后外侧融合术治疗退行性腰椎滑脱症的Meta分析[J]. 浙江创伤外科, 2020, 25(4): 718-721. doi: 10.3969/j.issn.1009-7147.2020.04.052
|
[2] |
陈文, 赵继荣, 薛旭, 等. MIS-TLIF与PLIF治疗单节段退行性腰椎疾病的临床疗效比较[J]. 中国老年学杂志, 2020, 40(15): 3224-3227. doi: 10.3969/j.issn.1005-9202.2020.15.029
|
[3] |
FOLEY K T, LEFKOWITZ M A. Advances in minimally invasive spine surgery[J]. Clin Neurosurg, 2002, 49: 499-517.
|
[4] |
薛文, 管晓鹂, 刘林, 等. Quadrant通道下MIS-TLIF联合膨胀式椎弓根螺钉治疗老年脊柱化脓性骨髓炎[J]. 中国骨伤, 2019, 32(10): 937-940. doi: 10.3969/j.issn.1003-0034.2019.10.013
|
[5] |
蒲俊刚, 王腾羽, 王钟, 等. Wiltse入路结合改良TLIF治疗中重度腰椎滑脱症的临床疗效[J]. 局解手术学杂志, 2020, 29(8): 630-635. https://www.cnki.com.cn/Article/CJFDTOTAL-JJXZ202008007.htm
|
[6] |
卢洋, 王瑜, 李征宇, 等. Quadrant通道下改良微创TLIF术在腰椎间盘突出症中的应用研究[J]. 解放军医药杂志, 2020, 32(5): 86-89. doi: 10.3969/j.issn.2095-140X.2020.05.021
|
[7] |
宋国涛. ALLIF对Ⅰ度退变性腰椎滑脱患者影像学参数及ODI指数的影响[J]. 医学理论与实践, 2020, 33(13): 2141-2143. https://www.cnki.com.cn/Article/CJFDTOTAL-YXLL202013039.htm
|
[8] |
刘剑伟, 蒋卫平. Quadrant通道下MIS-TLIF联合单侧椎弓根钉内固定治疗复发腰椎间盘突出症的疗效分析[J]. 中国骨与关节损伤杂志, 2019, 34(11): 1176-1178. doi: 10.7531/j.issn.1672-9935.2019.11.020
|
[9] |
GE D H, STEKAS N D, VARLOTTA C G, et al. Comparative analysis of two transforaminal lumbar interbody fusion techniques: open TLIF versus wiltse MIS TLIF[J]. Spine, 2019, 44(9): E555-E560. doi: 10.1097/BRS.0000000000002903
|
[10] |
SAYARI A J, PATEL D V, YOO J S, et al. Device solutions for a challenging spine surgery: minimally invasive transforaminal lumbar interbody fusion (MIS TLIF)[J]. Expert Rev Med Devices, 2019, 16(4): 299-305. doi: 10.1080/17434440.2019.1601013
|
[11] |
ZHAO Y F, LIANG Y, MAO K Y. Radiographic and clinical outcomes following MIS-TLIF in patients with adult lumbar degenerative scoliosis[J]. J Orthop Surg Res, 2018, 13(1): 93. doi: 10.1186/s13018-018-0764-7
|
[12] |
KIM J S, JUNG B, LEE S H. Instrumented minimally invasive spinal-transforaminal lumbar interbody fusion (MIS-TLIF): minimum 5-year follow-up with clinical and radiologic outcomes[J]. Clin Spine Surg, 2018, 31(6): E302-E309. doi: 10.1097/BSD.0b013e31827415cd
|
[13] |
ZHAO Y W, JIA J, LIU W B, et al. Influence of contoured versus straight rod on clinical outcomes and sagittal parameters in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) at L4/5 level-more than 5 years follow-up[J]. J Orthop Sci, 2020, 25(1): 89-95. doi: 10.1016/j.jos.2019.03.008
|
[14] |
左镇华, 朱明, 张时文, 等. PTED治疗腰椎间盘突出的手术效果及对CPK、IL-1β、CRP、5-HT水平的影响[J]. 解放军预防医学杂志, 2018, 36(8): 1022-1024, 1059. https://www.cnki.com.cn/Article/CJFDTOTAL-JYYX201808019.htm
|
[15] |
汤雄飞, 钱越宁, 顾宣歆, 等. 后路经椎旁肌间隙入路椎弓根螺钉内固定对腰椎骨折患者关节与功能恢复及血清磷酸肌酸激酶水平的影响[J]. 中国现代医生, 2017, 55(13): 71-74. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYS201713021.htm
|
[16] |
HOCKLEY A, GE D, VASQUEZ-MONTES D, et al. Minimally invasive versus open transforaminal lumbar interbody fusion surgery: an analysis of opioids, nonopioid analgesics, and perioperative characteristics[J]. Global Spine J, 2019, 9(6): 624-629. doi: 10.1177/2192568218822320
|
[17] |
CHEN Y C, ZHANG L, LI E N, et al. An updated meta-analysis of clinical outcomes comparing minimally invasive with open transforaminal lumbar interbody fusion in patients with degenerative lumbar diseases[J]. Medicine, 2019, 98(43): e17420. doi: 10.1097/MD.0000000000017420
|
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