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首页> 外文期刊>Asian spine journal. >Clinical and Radiological Outcomes of Modified Mini-Open and Open Transforaminal Lumbar Interbody Fusion: A Comparative Study
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Clinical and Radiological Outcomes of Modified Mini-Open and Open Transforaminal Lumbar Interbody Fusion: A Comparative Study

机译：改良的微型开放式和开放式经椎间孔腰椎椎间融合器的临床和放射学结果：对比研究

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Study Design Retrospective cohort study. Purpose To compare the clinical and radiological outcomes of modified mini-open transforaminal lumbar interbody fusion (modMOTLIF) and open TLIF (OTLIF). Overview of Literature Minimally invasive transforaminal lumbar interbody fusion (MTLIF) is associated with less blood loss, shorter hospital stay, and less pain. However, it has concerns like increased radiation exposure, steep learning curve, and instrumentation cost. We modified the MTLIF technique by direct freehand insertion of pedicle screws using stab incisions without tubular retractors. Methods The study included 24 patients in the modMOTLIF group and 27 patients in the OTLIF group. The average follow-up period was 25.6 months. Clinical outcomes were measured using Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores. Serial X-rays were acquired at 1, 3, 6, 12, and 24 months to assess the union and presence of instability. We also compared blood loss and length of hospital stay in both groups. Results All patients showed progressive improvement in VAS and ODI scores. No differences were observed in the preoperative and postoperative ODI and VAS leg scores between the groups. The immediate postoperative VAS back score was significantly higher in the OTLIF group than in the modMOTLIF group; however, no difference was observed at 1 and 2 years. Radiological analysis showed nonunion in one and two patients in the OTLIF and modMOTLIF groups, respectively. The average blood loss was 63 mL in the mod-MOTLIF group and 254 mL in the OTLIF group. The mean hospital stay was 3 days for the modMOTLIF group and 5 days for the OTLIF group. Conclusions modMOTLIF was associated with reduced blood loss and shorter hospital stay compared with OTLIF. No significant differences were observed in the clinical and radiological outcomes between the groups after 2 years despite reduced back pain in the immediate postoperative period in patients who underwent modMOTLIF.
机译：研究设计回顾性队列研究。目的比较改良的微型开放式经椎间孔腰椎椎间融合器（modMOTLIF）和开放式TLIF（OTLIF）的临床和放射学结果。文献概述微创经椎间孔腰椎椎间融合术（MTLIF）与失血量少，住院时间短和痛苦少有关。然而，它具有增加辐射暴露，陡峭的学习曲线和仪器成本等问题。我们通过使用不带管状牵开器的刺切口直接徒手插入椎弓根螺钉来修改MTLIF技术。方法该研究包括modMOTLIF组的24例患者和OTLIF组的27例患者。平均随访期为25.6个月。使用视觉模拟量表（VAS）和Oswestry残疾指数（ODI）评分来衡量临床结局。在1、3、6、12和24个月获取了连续的X射线，以评估联合和不稳定的存在。我们还比较了两组的失血量和住院时间。结果所有患者的VAS和ODI评分均逐渐改善。两组之间的术前和术后ODI和VAS腿评分没有差异。 OTLIF组术后立即VAS评分明显高于modMOTLIF组。但是，在1年和2年时未观察到差异。放射学分析显示，OTLIF和modMOTLIF组分别有1例和2例患者出现骨不连。 mod-MOTLIF组的平均失血量为63 mL，OTLIF组的平均失血量为254 mL。 modMOTLIF组的平均住院时间为3天，OTLIF组的平均住院时间为5天。结论与OTLIF相比，modMOTLIF可减少失血量并缩短住院时间。尽管接受modMOTLIF治疗的患者在术后即刻减轻了背部疼痛，但2年后两组之间的临床和放射学结果均未见明显差异。

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