Early therapeutic effect of minimal access open surgery of TLIF for the treatment of lumbar degenerative disease

WU Meixiang; HE Erxing; WU Jingming; BAI Bo; LIN Zhixiong; LI Wen; YIN Zhixun; ZHONG Shushan

doi:10.3969/j.issn.1674-666X.2013.03.004

Abstract：Objective To evaluate early therapeutic effect of minimal access open surgery of transforaminal lumbar interbody fusion (MA-OTLIF) for lumbar degenerative disease (LDD). Methods From January 2010 to December 2012, 32 patients with single-level unilateral LDD were treated surgically in the First Affiliated Hospital of Guangzhou Medical University. They were divided into MA-OTLIF group and minimally invasive TLIF (MIS-TLIF) group randomly by sortition method (n = 16). Length of incision, operation time, intraoperative estimate blood loss, times of X-ray exposure, complications, hospital stay and visual analogue scale (VAS) scores at 1 week and 6 months after the surgery were compared between two groups. Results All patients were followed up from 6 to 36 months, with the average of 15.8 months. No complications such as nerve root injuries, rupture of dura mater, cerebrospinal fluid leakage, pedicle screw misplacement and surgical site infection had happened. Length of incision in MA-OTLIF group was longer than that in MIS-TLIF, but operation time and times of X-ray exposure in MA-OTLIF group were shorter than those in MIS-TLIF (P <0.05). As for intraoperative estimate blood loss and hospital stay, there had no statistical differences between two groups (P >0.05). Compared with preoperative VAS scores (7.6 ± 0.8) in MA-OTLIF group and (7.6 ± 0.8) in MIS-TLIF group, those at 1 week and 6 months after the surgery were improved to (1.3 ± 0.7) and (1.2 ± 0.6) in MA-OTLIF group, and (1.1 ± 1.0) and (1.2 ± 0.8) in MIS-TLIF group respectively (P <0.05). Conclusions MA-OTLIF could obtain satisfied short-term effects for LDD patients, which not only provides similar surgical exposure, but also has the same minimally invasive advantages as MIS-TLIF.