Clinical and radiographic comparison of mini-open transforaminal lumbar interbody fusion with open transforaminal lumbar interbody fusion in 42 patients with long-term follow-up

被引:266
作者
Dhall, Sanjay S. [1 ,3 ]
Wang, Michael Y. [2 ]
Mummaneni, Praveen V. [1 ]
机构
[1] Univ Calif San Francisco, Dept Neurosurg, San Francisco, CA 94143 USA
[2] Univ Miami, Dept Neurosurg, Miami, FL USA
[3] Emory Univ, Dept Neurosurg, Atlanta, GA 30322 USA
关键词
degenerative disc disease; minimally invasive surgery; transforaminal lumbar interbody fusion;
D O I
10.3171/SPI.2008.9.08142
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Object. As minimally invasive approaches gain popularity in spine surgery. clinical Outcomes and effectiveness of mini-open transforaminal lumbar interbody fusion (TLIF) compared with traditional open TLIF have yet to be established. The authors retrospectively compared the outcomes of patients Who underwent mini-open TLIF with those who underwent open TLIF Methods. Between 2003 and 2006. 42 patients underwent TLIF for degenerative disc disease or spondylolisthesis 21 patients underwent mini-open TLIF and 21 patients underwent open TLIF The mean age in each group was 53 years, and there was no statistically significant difference in age between the groups (p = 0.98). Data were collected perioperatively. In addition, complications, length of stay (LOS), fusion rate, and modified Prolo Scale (mPS) scores were recorded at routine intervals. Results. No patient was lost to follow-up. The mean follow-up was 24 months for the mini-open group and 34 months for the open group. The mean estimated blood loss was 194 nil for the mini-open group and 505 ml for the open group (P < 0.01). The mean LOS was 3 days for the mini-open group and 5.5 days for the open group (1) < 0.01). The mean mPS score improved from 11 to 19 in the mini-open group and from 10 to 18 in the open group there was no statistically significant difference in mPS score improvement between the groups (p = 0.19). In the mini-open group there were 2 cases of transient L-5 sensory loss, 1 case of a misplaced screw that required revision, and 1 case of cage migration that required revision. In the open group there was 1 case of radiculitis as well as 1 case of a misplaced screw that required revision. One patient in the mini-open group developed a pseudarthrosis that required reoperation, and all patients in the open group exhibited fusion. Conclusions. Mini-open TLIF is a viable alternative to traditional open TLIF with significantly reduced estimated blood loss and LOS. However. the authors found a higher incidence of hardware-associated complications with the mini-open TLIF (DOI: 10.3171/SPI.2008.9.08142)
引用
收藏
页码:560 / 565
页数:6
相关论文
共 29 条
  • [1] Deutsch Harel, 2006, Neurosurg Focus, V20, pE10
  • [2] Minimally invasive percutaneous posterior lumbar interbody fusion
    Fessler, RG
    [J]. NEUROSURGERY, 2003, 52 (06) : 1512 - 1512
  • [3] Foley K.T., 2001, Neurosurg. Focus, V10, P1, DOI [DOI 10.3171/FOC.2001.10.4.11, DOI 10.3171/foc.2001.10.4.11]
  • [4] Foley Kevin T, 2002, Clin Neurosurg, V49, P499
  • [5] Minimally invasive lumbar fusion
    Foley, KT
    Holly, LT
    Schwender, JD
    [J]. SPINE, 2003, 28 (15) : S26 - S35
  • [6] Percutaneous pedicle screw fixation of the lumbar spine: preliminary clinical results
    Foley, KT
    Gupta, SK
    [J]. JOURNAL OF NEUROSURGERY, 2002, 97 (01) : 7 - 12
  • [7] Serial changes in trunk muscle performance after posterior lumbar surgery
    Gejo, R
    Matsui, H
    Kawaguchi, Y
    Ishihara, H
    Tsuji, H
    [J]. SPINE, 1999, 24 (10) : 1023 - 1028
  • [8] A ONE-STAGER PROCEDURE IN OPERATIVE TREATMENT OF SPONDYLOLISTHESES - DORSAL TRACTION-REPOSITION AND ANTERIOR FUSION
    HARMS, J
    ROLINGER, H
    [J]. ZEITSCHRIFT FUR ORTHOPADIE UND IHRE GRENZGEBIETE, 1982, 120 (03): : 343 - 347
  • [9] Holly Langston T, 2006, Neurosurg Focus, V20, pE6
  • [10] Minimally invasive microendoscopy-assisted transforaminal lumbar interbody fusion with instrumentation
    Isaacs, RE
    Podichetty, VK
    Santiago, P
    Sandhu, FA
    Spears, J
    Kelly, K
    Rice, L
    Fessler, RG
    [J]. JOURNAL OF NEUROSURGERY-SPINE, 2005, 3 (02) : 98 - 105