Efficacy of modified minimally invasive transforaminal lumbar interbody fusion for the treatment of lumbar degenerative diseases
ZHANG Guoteng
WANG Yi
ZHANG Zhida
ZHOU Pei
ZHOU Jianpeng
Abstract：Objective To investigate the clinical efficacy of modified minimally invasive lumbar interbody fusion(mis-TLIF)in the treatment of lumbar degenerative diseases.Methods A retrospective analysis was conducted on 39 patients with lumbar degenerative diseases treated with modified mis-TLIF surgery at the Department of Orthopedics,the Affiliated Guangzhou Hospital of TCM of Guangzhou University of Chinese Medicine from January 2021 to November 2022,including 15 males and 24 females,aged from 28-90(66.08±13.95)years old.12 patients underwent modified mis-TLIF surgery,while 27 patients underwent modified mis-TLIF combined with ULBD surgery.Surgical time,intraoperative bleeding volume,and complications were recorded.Visual analog scale(VAS)scores for low back and leg pain,as well as Oswestry disability index(ODI),were collected before surgery,1 week and 3 months after surgery,and at the final follow-up.The MacNab criteria were employed to evaluate the clinical efficacy at the final follow-up.Results All patients underwent surgery successfully and were followed up for 12-28(17.49±5.05)months.The operation time ranged from 76-190(106.67±33.01)min,and the intraoperative bleeding volume ranged from 110-447(225.38±87.90)mL.One case of dural matter tear occurred during the surgery,which was repaired with an absorbable dural patch without subsequent cerebrospinal fluid leakage.No nerve injuries were observed in all cases.Postoperatively,37 cases achieved primary healing of wounds;1 case developed superficial infection at the incision site,and the wound healed after receiving sensitive antibiotics and symptomatic debridement;Another case presented with a suture reaction at the incision,which resolved after symptomatic debridement alone;Deep infection did not occur in either case.No cardiovascular or cerebrovascular accidents occurred in any patient during or after surgery.The VAS scores for low back pain at preoperative,1 week postoperative,3 months postoperative,and the final follow-up were 8.27±0.76,2.49±0.76,1.46±0.64,0.94±0.48,respectively.The VAS scores for leg pain were 8.69±0.68,1.91±0.63,1.16±0.54,0.78±0.43,respectively.The ODI scores(%)were 81.98±10.07,27.47±9.31,18.98±7.37,14.66±5.54,respectively.At all postoperative time points,there were statistically significant improvements in VAS scores for low back and leg pain,as well as ODI scores,compared to preoperative values(P<0.05).Pairwise comparisons of VAS scores for low back and leg pain between each postoperative time point also showed statistical significance(P<0.05).At the final follow-up,according to the MacNab criteria,20 cases were excellent,16 cases were good,3 cases were acceptable,resulting in an excellent and good rate of 92.31%.Conclusion The modified mis-TLIF surgery for the treatment of lumbar degenerative diseases is a minimally invasive,safe and effective surgical method,but its long-term clinical efficacy still needs further follow-up observation.
Keywords：minimally invasive TLIFlumbar degenerative diseaseslumbar-leg pain
Publication Date：2025-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 459-465 )