开放式与微创经椎间孔腰椎椎体间融合术的临床与影像学结果比较

Waqas Noor Chughtai, M. Razzaque, Tanveer Ahmad, M. Rehman, A. Rashid, Amjad Maqsood
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摘要

目的:比较开放式TLIF和微创TLIF的临床、影像学和功能预后。研究设计:前瞻性队列研究地点和时间:研究于2021年8月至2022年7月在木尔坦市Bakhtawar Amin医院神经外科进行,为期一年。方法:共纳入94例计划行椎间孔腰椎椎体间融合术(TLIF)的患者。研究的主要变量为术中出血量、手术时间、VAS评分、ODI指数和功能评分。采用SPSS 24版进行数据分析,采用t检验和卡方检验检验变量间的相关性。P值小于或等于0.05为显著性。结果:术后3周,O-TLIF组和MIS-TLIF组的Oswestry残疾指数读数分别为35.16±2.18和5.12±0.61。差异无统计学意义(p>0.050)。两组在不同时间间隔的身体成分总结均显示MIS-TLIF组疗效更好,除6周外无统计学差异。两组的心理成分总结基本相等(p>0.050)。意义:TLIF的开放性与微创性治疗方法在国内尚无比较研究,我们的研究将填补国内的参考空白,为今后术者选择更好的治疗方法提供参考。结论:微创手术TLIF技术对软组织损伤和医源性损伤具有较好的即时疗效,且术后疼痛功能恢复时间较长。因此,微创椎间融合术对于短期(失血,术后疼痛)和长期(功能恢复)是一种安全可靠的选择。关键词:椎间融合,VAS评分,SF-36, ODI指数,TLIF技术
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A Comparison of Clinical and Radiological Outcomes between Open and Minimally Invasive Transforaminal Lumbar Interbody Fusion
Objective: To compare the clinical, radiological and functional outcomes of patients between open TLIF and minimally invasive TLIF techniques. Study Design: Prospective cohort study Place and duration: Study was conducted at department of neurosurgery Bakhtawar Amin Hospital, Multan from August 2021 to July 2022 in duration of one year. Methodology: A total of 94 patients planned for transforaminal lumbar interbody fusion (TLIF) were enrolled in study. Main variables of study were intra operative blood loss, duration of surgery, VAS score, ODI index and functional score. SPSS version 24 was used for data analysis, t-test and chi square test were applied to see association among variables. P value less than or equal 0.05 was considered as significant. Results: Oswestry disability index readings were 35.16±2.18 and 5.12±0.61 in O-TLIF and MIS-TLIF groups respectively at 3 weeks after surgery. The differences were statistically insignificant, (p>0.050). Physical component summary of both the groups at different time intervals as shown better outcomes in MIS-TLIF group, no difference was found to be statistically significant except at 6 week. Mental component summary in both the groups was almost equal, (p>0.050). Implications: There was no local study on comparison of open and minimally invasive technique for TLIF, our study will fulfill the local reference gap and help the surgeons for choice of better management technique in future. Conclusion: Minimally invasive surgery TLIF technique is better in immediate benefits as soft tissue injury and iatrogenic injury which is associated with better post operative pain functional recovery time. So, minimal invasive interbody fusion is a safe and reliable option for short term (blood loss, post operative pain) and long term outcomes like functional recovery. Keywords: Interbody fusion, VAS score, SF-36, ODI index, TLIF Technique
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