Minimally invasive transforaminal lumbar interbody fusion through Quadrant channel for treatment of lumbar degenerative diseases

doi:10.3969/j.issn.2095-4344.1935

Abstract

Abstract:

BACKGROUND: Traditional transforaminal lumbar interbody fusion (TLIF) surgery for lumbar degenerative diseases is effective, but it will lead to adverse intraoperative hemorrhage and slow postoperative recovery because of severe trauma. With the continuous development of minimally invasive techniques in spinal surgery, minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) through the Quadrant channel is gradually applied in the treatment of lumbar degenerative diseases.

OBJECTIVE: To compare the clinical efficacy of MIS-TLIF versus traditional TLIF in the treatment of lumbar degenerative diseases．

METHODS: A total of 54 patients with the lumbar degenerative diseases who received treatment from January 2015 to July 2016 in Zhangjiagang First People’s Hospital, Soochow University were retrospectively analyzed. These patients were randomly assigned to receive MIS-TLIF through the Quadrant channel (n=24) or traditional TLIF (n=30). All patients provided written informed consent and the study was approved by Medical Ethics Committee of Zhangjiagang First People’s Hospital. The length of surgical incision, operation time, intraoperative blood loss, and postoperative drainage volume were compared between these two groups. In addition, prior to surgery, and 3 days, 3, 6, 12 months after surgery, Visual Analogue Scale score with 0 indicating no pain and 10 representing most severe pain was recorded. Oswestry disability index was recorded prior to surgery and 3, 6, and 12 months after surgery.

RESULTS AND CONCLUSION: (1) All 54 patients successfully completed the surgery. (2) Intraoperative blood loss, length of incision, postoperative drainage volume were significantly lower in the MIS-TLIF group than in the traditional TLIF group (P < 0.05); but the operation time was longer (P < 0.05). (3) There were no significant differences in Visual Analogue Scale score and Oswestry disability index pre-surgery between MIS-TLIF and traditional TLIF groups (P > 0.05). At 3 days and 3 months after surgery, Visual Analogue Scale score in the MIS-TLIF group was significantly lower than that in the traditional TLIF group (P < 0.05). However, no significant difference in Visual Analogue Scale score was observed between these two groups at 6 months and 1 year after surgery (P > 0.05). At 3 months after surgery, Oswestry disability index in the MIS-TLIF group was significantly lower than that in the traditional TLIF group (P < 0.05). However, there was no significant difference in Oswestry disability index between these two groups at 6 months and 1 year after surgery (P > 0.05). (4) Postoperative imaging follow-up showed satisfactory surgical results and good interbody fusion. (5) These results suggest that MIS-TLIF through Quadrant channel is a minimally invasive operation for the treatment of lumbar degenerative diseases, and has the advantages of less intraoperative blood loss, less trauma and early postoperative rehabilitation compared with the traditional TLIF.

Key words: bone biomaterials, lumbar degenerative diseases, Quadrant channel, minimally invasive, lumbar interbody fusion

CLC Number:

R459.9|R318|R687

Huang Qun, Sheng Xiaolei, Yan Fei, Zhou Zhiping, Zhu Xianwei. Minimally invasive transforaminal lumbar interbody fusion through Quadrant channel for treatment of lumbar degenerative diseases[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(36): 5818-5823.

Figures/Tables 3

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