Minimally invasive transforaminal lumbar interbody fusion versus posterior open-surgery in treatment of lumbar spondylolisthesis / 中华骨科杂志

ABSTRACT

ObjectiveTo compare the clinical results between minimally invasive transforaminal lumbar(mini-TLIF) and posterior open surgery in treatment of lumbar spondylolisthesis.MethodsFrom March 2008 to August 2010,a total of 49 cases with lumbar spondylolisthesis underwent surgical intervention were retrospectively analyzed,including 23 cases with mini-TLIF and 26 with open surgery.Operation time,intra-operative bleeding,and radiation exposure times were recorded.Pre- and postoperative back pain was assessed by visual analogue scale(VAS),and lumbar function was evaluated by Oswestry disability index (ODI).The clinical results were assessed by Macnab criterion,and the pre and postoperative radiologic parameters were compared.ResultsThe mean follow-up time was 11 months(ranged,9-22).Both groups got good clinical results and satisfactory radiologic parameters.The group of mini-TLIF was superior to the group of open surgery in intra-operative bleeding,VAS of the second day postoperatively and the willingness of reoperation(P＜0.05).The ODI in the patients with open surgery were decreased from 31.2％±8.2％ to 16.1％±6.8％ corresponding to the pre-oporation and the final follow-up.The ODI in the patients with mini-TLIF were decreased from 34.4％±11.7％ to 15.3％±4.3％ corresponding to the pre-operation and the final follow-up.There is no significant difference of the change of ODI between two groups (t=0.673,P=0.412).The group of mini-TLIF need more operation time and were exposed to more X-ray when compared to the open surgery group(P＜0.05).ConclusionMini-TLIF and open surgery can both get satisfactory clinical outcomes in treatment of lumbar spondylolisthesis.Mini-TLIF was superior to open surgery in intra-operative bleeding and VAS of the second day postoperatively,but it needs more operation time and radiation exposure.