关键词: 骨关节植入物, 脊柱植入物, 腰椎间盘突出症, 三维导航, 微创, 椎间融合, 疼痛目测类比评分, 腰椎疾患疗效评分, 单节段, 内固定

Abstract:

BACKGROUND: Navigation assisted minimally invasive posterior lumbar interbody fusion and pedicle screw fixation can precisely real-time guide a variety of operation under minimally invasive sleeve, and implant the pedicle screws and interbody fusion cage and other implants safely and accurately, thus can determine the decompression parts. Minimally invasive transforaminal lumbar interbody fusion is the typical approach in recent years for the successful application of minimally invasive spine surgery techniques with the advantages of small incision, less bleeding, slight tissue damage and faster recovery.
OBJECTIVE: To evaluate the short-term effect of minimally invasive transforaminal lumbar interbody fusion with real-time three-dimensional navigation system and open posterior transforaminal lumbar interbody fusion.
METHODS: Forty cases with single-level lumbar disc herniation were retrospectively analyzed. The patients were treated with minimally invasive transforaminal lumbar interbody fusion with real-time three-dimensional navigation system (20 cases) and open posterior transforaminal lumbar interbody fusion (20 cases) respectively for the comparative analysis. The fusion duration, intraoperative blood loss, postoperative drainage volume, the length of postoperative hospital stay and the length of hospital stay were compared between two groups. The wound pain and function were evaluated after treatment with visual analogue scale score and Japanese Orthopaedic Association score.
RESULTS AND CONCLUSION: All patients were followed-up for 7.7 months. The operative duration in the minimally invasive transforaminal lumbar interbody fusion group was longer than that in the open posterior transforaminal lumbar interbody fusion group, and the difference was significant (P < 0.01); the length of hospital stay and length of postoperative hospital stay of the minimally invasive transforaminal lumbar interbody fusion group were shorter than the open posterior transforaminal lumbar interbody fusion group, and the differences were significant (P < 0.01); the intraoperative blood loss of the minimally invasive transforaminal lumbar interbody fusion group was less than the open posterior transforaminal lumbar interbody fusion group, and the difference was significant (P < 0.05); the postoperative drainage volume of the minimally invasive transforaminal lumbar interbody fusion group was less than the open posterior transforaminal lumbar interbody fusion group, and the difference was significant (P < 0.01). The visual analogue scale score was significantly decreased and the Japanese Orthopaedic Association score was significantly increased in the minimally invasive transforaminal lumbar interbody fusion group at 3 days after internal fixation compared with open posterior transforaminal lumbar interbody fusion group (P< 0.01), but there were no significant differences in the visual analogue scale score and Japanese Orthopaedic Association score between the two groups before operation and 6 months after operation (P > 0.05).The results indicate that minimally invasive transforaminal lumbar interbody fusion with real-time three-dimensional navigation system is an effective method for lumbar disc herniation with the advantages of less intraoperative blood loss, less postoperative drainage volume, small trauma, short hospital stay and short-term efficacy.

Key words: bone and joint implants, spinal implants, lumbar disc herniation, three-dimensional navigation, minimally invasive, interbody fusion, visual analogue scale, Japanese Orthopaedic Association score, single-level, internal fixation