Treatment of minimally invasive posterior lumbar interbody fusion via Quadrant channel for single-segment degenerative lumbar spine diseases

WANG Yefeng; ZOU Tianming

doi:10.3969/j.issn.1674-666X.2016.05.008

Abstract：Objective To investigate the clinical effect of minimally invasive posterior lumbar interbody fusion via Quadrant channel in the treatment of single-segment degenerative diseases of lumbar spine. Methods Twelve patients with single-segment lumbar degenerative diseases treated in Suzhou Affiliated Hospital of Nanjing Medical University from November 2014 to March 2016 were included in the study, who underwent minimally invasive posterior lumbar interbody fusion via the gap of multifidus muscle and the longest muscle under Quadrant channel, including 10 patients with posterior lumbar interbody fusion and 2 patients with posterolateral fusion. Their clinical data were retrospectively analyzed. Operation time, intraoperative blood loss, postoperative drainage volume, postoperative hemoglobin level, pain visual analogue scale (VAS) score and Oswestry disability index (ODI) before and after the surgery were recorded. Results Operation time was 120 to 260 min, with an average of 180 min. Intraoperative blood loss was 50 to 800 mL (average, 375 mL). Postoperative drainage volume was 8 to 321 mL (average, 128 mL). The hemoglobin level was 93 to 138 g/L, and the mean value was 113 g/L. No cerebrospinal fluid leakage, nerve root injury, infection or intractable low back pain was found in all patients. After 5 to 21 month' follow-up (average, 10 months), the average score of VAS and ODI was (2.0 ± 0.7) points and (46 ± 10) points, showed improvement compared with preoperative (6.4 ± 1.0) points and (18 ± 4 points). The differences between preoperation and the last follow-up had statistical significance (P <0.05). Conclusion For single-segment degenerative lumbar spine diseases, posterior lumbar interbody fusion via the gap of multifidus muscle and the longest muscle under Quadrant channel has the advantages of less blood loss, less damage to the posterior ligaments, better spinal stability, faster postoperative recovery, which is consistent with minimally invasive concept and worthy of clinical application.