Objective 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.
Methods 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.
Results 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.
Conclusion 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.
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