Comparison of clinical and radiographic outcomes in unilateral transforaminal lumbar interbody fusion: a retrospective analysis of three surgical approaches.
Guanyi Liu, Xuan Wang, Jiawei Zhang, Nanjian Xu, Lu Mao, Jun Qian, Xuyu Liao, Leijie Zhou, Yadan Niu
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引用次数: 0
Abstract
Purpose: The primary objective of this study is to evaluate and compare the clinical and radiographic outcomes of the combined spinous process-splitting approach with a Wiltse (SPSW) approach, the combined conventional approach with a Wiltse (CW) approach, and the conventional open (CO) approach in unilateral transforaminal lumbar interbody fusion (TLIF).
Methods: The clinical outcomes were assessed, and intraoperative data and complications were collected. Numeric Rating Scale (NRS) scores for low back pain and leg pain, the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) scores for evaluating functions of the lumbar spine and health-related quality of life, and the modified MacNab standard for assessing satisfaction were analyzed. Radiographic outcomes included disc space height, segmental lordosis, interbody fusion assessment, and the rate of muscle atrophy of the multifidus and the erector spinae muscles.
Results: Among the three groups, the SPSW group exhibited the shortest operation and drain retention time, lowest intraoperative blood loss, and minimal postoperative blood loss. Notably, the SPSW group displayed the highest level of social life function based on the JOABPEQ, and the highest level of patient satisfaction according to the modified MacNab Criteria, along with the lowest rate of muscle atrophy.
Conclusion: All the SPSW, CW, and CO approach TLIF procedures achieved overall satisfactory effects of decompression and fusion for lumbar degenerative diseases. The SPSW approach procedure appears to be associated with the smallest surgical trauma and highest satisfaction because of reducing iatrogenic injury of the paraspinal muscles.
期刊介绍:
"European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts.
Official publication of EUROSPINE, The Spine Society of Europe