Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (24): 3790-3795.doi: 10.12307/2021.081

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Computer-assisted navigation combined with minimally invasive transforaminal lumbar interbody fusion for lumbar spondylolisthesis

Qian Xuankun, Huang Hefei, Wu Chengcong, Liu Keting, Ou Hua, Zhang Jinpeng, Ren Jing, Wan Jianshan   

  1. Department of Spine Surgery, No.1 People’s Hospital of Qujing, Qujing 655000, Yunnan Province, China
  • Received:2020-09-25 Revised:2020-09-28 Accepted:2020-11-09 Online:2021-08-28 Published:2021-03-05
  • Contact: Ren Jing, Associate chief physician, Department of Spine Surgery, No.1 People’s Hospital of Qujing, Qujing 655000, Yunnan Province, China Wan Jianshan, Chief physician, Department of Spine Surgery, No.1 People’s Hospital of Qujing, Qujing 655000, Yunnan Province, China
  • About author:Qian Xuankun, Master, Attending physician, Department of Spine Surgery, No.1 People’s Hospital of Qujing, Qujing 655000, Yunnan Province, China
  • Supported by:
    the Scientific Research Foundation Project of Yunnan Provincial Department of Education, No. 2016ZDX074 (to WCC) 

Abstract: BACKGROUND: At present, some studies have reported that navigation assisted spinal surgery has the characteristics of visualization and precision compared with traditional surgery, and this tail will further explore and study it.
OBJECTIVE: To compare the clinic effect between minimally invasive transforaminal lumbar interbody fusion with computer navigation and open transforaminal lumbar interbody fusion in the treatment of lumbar spondylolisthesis and provide evidence to choose a batter operative method. 
METHODS: A retrospective analysis of 60 patients with lumbar spondylolisthesis who were hospitalized at the Department of Spine Surgery, No.1 People’s Hospital of Qujing from March 2014 to March 2018 undergoing transforaminal lumbar interbody fusion was conducted. Of them, 30 cases were treated with navigation and microendoscopic discectomy (minimally invasive group); other 30 cases underwent open-transforaminal lumbar interbody fusion and pedicle screw fixation (open group). Operation time, blood loss, postoperative drainage volume, postoperative bedridden time, hospitalization time, and complications were collected in both groups. Visual analogue scale scores and Oswestry disability index were followed up. Accuracy of pedicle screw insertion and bone graft fusion rate were assessed using imaging examination between the two groups. Above indexes were statistically analyzed and compared between the two groups.  
RESULTS AND CONCLUSION: (1) All patients were followed up from 12 to 40 months. (2) There were no significant differences between two groups in age, sex, preoperative visual analogue scale, Oswestry disability index, and level of spondylolysis (P > 0.05). (3) The operation time was slightly longer in the minimally invasive group than in the open group, but there was no significant difference in operation time between the two groups (P > 0.05). The blood loss, the postoperative drainage volume, bedridden time and hospitalization time of minimally invasive group were significantly less than those of open group (P < 0.05). (4) Oswestry disability index and back pain visual analogue scale scores were significantly decreased after treatment in both groups; moreover, visual analogue scale scores and Oswestry disability index of minimally invasive group were lower than that of open group after operation (P < 0.05). (5) The accuracy of pedicle screw insertion of minimally invasive group was superior to that of open group (P < 0.05). (6) No obvious internal fixation loosening, broken, or abnormal activities were found in all patients during the follow-up. There was no significant difference in the bone graft fusion rate between the two groups at the last follow-up. (7) It is indicated that compared with the open transforaminal lumbar interbody fusion, computer-assisted navigation combined with microendoscopic discectomy channel minimally invasive transforaminal lumbar interbody fusion treatment for lumbar spondylolisthesis has advantages of less blood loss, less trauma, less bedridden time, rapid recovery, higher accuracy of pedicle screw insertion, which is a good selection for lumbar fusion. 

Key words: computer navigation, intervertebral disc endoscope, lumbar spondylolisthesis, minimally invasive, transforaminal lumbar interbody fusion

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