Temporal Trends of Improvement After Minimally Invasive Transforaminal Lumbar Interbody Fusion.

IF 2.6 2区医学 Q2 CLINICAL NEUROLOGY Spine Pub Date : 2025-01-15 Epub Date: 2024-05-06 DOI:10.1097/BRS.0000000000005024

Pratyush Shahi, Tejas Subramanian, Olivia Tuma, Sumedha Singh, Kasra Araghi, Tomoyuki Asada, Maximilian Korsun, Nishtha Singh, Chad Simon, Avani Vaishnav, Eric Mai, Joshua Zhang, Cole Kwas, Myles Allen, Eric Kim, Annika Heuer, Evan Sheha, James Dowdell, Sheeraz Qureshi, Sravisht Iyer

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Abstract

Study design: Retrospective review of prospectively collected data.

Objective: To analyze temporal trends in improvement after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).

Summary of background data: Although several studies have shown that patients improve significantly after MIS TLIF, evidence regarding the temporal trends in improvement is still largely lacking.

Methods: Patients who underwent primary single-level MIS TLIF for degenerative conditions of the lumbar spine and had a minimum of 2-year follow-up were included. Outcome measures were: 1) patient reported outcome measures (PROMs) (Oswestry Disability Index, ODI; Visual Analog Scale, VAS back and leg; 12-Item Short Form Survey Physical Component Score, SF-12 PCS); 2) global rating change (GRC); 3) minimal clinically important difference (MCID); and 4) return to activities. Timepoints analyzed were preoperative, 2 weeks, 6 weeks, 3 months, 6 months, 1 year, and 2 years. Trends across these timepoints were plotted on graphs.

Results: 236 patients were included. VAS back and VAS leg were found to have statistically significant improvement compared to the previous timepoint up to 3 months after surgery. ODI and SF-12 PCS were found to have statistically significant improvement compared to the previous timepoint up to 6 months after surgery. Beyond these timepoints, there was no significant improvement in PROMs. 80% of patients reported feeling better compared to preoperative by 3 months. >50% of patients achieved MCID in all PROMs by 3 months. Most patients returned to driving, returned to work, and discontinued narcotics at an average of 21, 20, and 10 days, respectively.

Conclusions: Patients are expected to improve up to 6 months after MIS TLIF. Back pain and leg pain improve up to 3 months and disability and physical function improve up to 6 months. Beyond these timepoints, the trends in improvement tend to reach a plateau. 80% of patients feel better compared to preoperative by 3 months after surgery.

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微创经椎间孔腰椎椎体间融合术后病情改善的时间趋势。

研究设计对前瞻性收集的数据进行回顾性分析：分析微创经椎间孔腰椎椎体间融合术（MIS TLIF）后病情改善的时间趋势：背景数据摘要：尽管多项研究显示，患者在接受微创经椎间孔腰椎椎体融合术（MIS TLIF）后病情明显好转，但有关病情好转的时间趋势的证据仍然十分缺乏：方法：纳入因腰椎退行性病变接受初级单水平 MIS TLIF 的患者，随访至少 2 年。结果测量包括1）患者报告的结果测量（PROMs）（Oswestry残疾指数，ODI；视觉模拟量表，VAS背部和腿部；12项简表调查身体成分得分，SF-12 PCS）；2）总体评分变化（GRC）；3）最小临床重要性差异（MCID）；4）恢复活动。分析的时间点包括术前、2 周、6 周、3 个月、6 个月、1 年和 2 年。结果：共纳入 236 名患者。与上一个时间点相比，VAS背部和VAS腿部在术后3个月内有显著改善。术后 6 个月内，ODI 和 SF-12 PCS 与之前的时间点相比有显著改善。超过这些时间点后，PROMs 没有明显改善。80% 的患者在术后 3 个月内感觉比术前更好。>超过 50% 的患者在 3 个月前的所有 PROMs 指标都达到了 MCID。大多数患者分别在平均 21 天、20 天和 10 天后恢复驾驶、重返工作岗位并停用麻醉药物：结论：MIS TLIF术后患者的病情有望在6个月内得到改善。结论：预计患者在 MIS TLIF 术后 6 个月内会有所改善，背痛和腿痛最多可改善 3 个月，残疾和身体功能最多可改善 6 个月。超过这些时间点后，改善趋势趋于平稳。80% 的患者在术后 3 个月感觉比术前更好。

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来源期刊

Spine 医学-临床神经学

CiteScore

5.90

自引率

6.70%

发文量

361

审稿时长

6.0 months

期刊介绍： Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store. Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.