Modified endoscopic PLIF combined with percutaneous pedicle screw fixation in the treatment of lumbar spondylolisthesis
TIAN Gang
SHEN Maorong
LIANG Weiguo
XIE Furong
WEI Wenwu
Abstract：Objective To explore the clinical efficacy of modified endoscopic posterior lumbar interbody fusion (PLIF) combined with percutaneous pedicle screw fixation for patients with lumbar spondylolisthesis. Methods Clinical data of 58 patients were analyzed retrospectively who were treated from March 2012 to February 2015 in Guangxi Orthopaedic Hospital, in which 27 patients performed endoscopic PLIF combined with percutaneous pedicle screw fixation (minimally invasive group), and 31 patients performed PLIF via the traditional approach with posterior midline sacrospinous muscle dissection (open group). The operative time, intraoperative estimate blood loss volume, incision length, postoperative ambulation time and complications in two groups were recorded; Visual analogue scale (VAS) scores of back pain and leg pain, Oswestry disability index (ODI) were evaluated at preoperation, 2 weeks as well as 1 and 3 months after the operation; At the last follow-up, clinical efficacy was accessed by modified MacNab standard, and bone fusion rate was calculated according to Suk standard. Results Intraoperative estimate blood loss, incision length, postoperative ambulation time in minimally invasive group were lower than those in open group (P <0.05), while the operation time was longer than that in open group (P <0.05); VAS scores and ODI in minimally invasive group were lower than those in open group 2 weeks and 1 month after the surgery (P <0.05), while there was no statistical difference at 3 months after the surgery (P >0.05). At the latest follow-up, clinical effects in minimally invasive group were superior than those in open group (P<0.05), while the difference of bone fusion rate in two groups had no statistical significance (P >0.05). No injuries of nerve root or nerve of cauda equina, wound infection were found. Conclusion The modified endoscopic PLIF combined with percutaneous pedicle screw fixation is a good choice for lumbar spondylolisthesis, which could relieve pain and neurological symptoms and obtain satisfactory effects, with less trauma, less bleeding, shorter recovery time compared with open surgery.
Keywords：Lumbar vertebraeIntervertebral disk displacementSpinal fusionEndoscopyBone screws
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 356-361 )