ABSTRACT
Objective To compare the clinical effect between minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) via Quadrant minimally invasive system and open transforaminal lumbar interboday fusion(TLIF) in treating lumbar degeneration disease.Methods Clinical data of 46 patients in the First Affiliated Hospital of Xinxiang Medical University from April 2016 to April 2017 with lumbar degenerative diseases who were given operation treatment were analyzed retrospectively.Twenty patients underwent MIS-TLIF via Quadrant minimally invasive system(MIS-TLIF group) and twenty-six patients underwent open-TLIF(open TLIF group).The blood loss,operative time,length of incision,volume of drainage after operation,time of ambulation,hospitalization time,hospitalization cost,postoperative complications,visual pain simulation (VAS) score and Oswestry disability index(ODI) at 1,3,6 and 12 months after operation were compared between the two groups.Results The blood loss,length of incision,volume of drainage after operation,time of ambulation,hospitalization time,hospitalization cost in the MIS-TLIF group were less than those in the open TLIF group (P ＜0.05);there was no significant difference in operative time between the two groups(P ＜0.05).The VAS score and ODI of the MIS-TLIF group were lower than those of the open TLIF group at 1 and 3 months after surgery (P ＜ 0.05);there was no significant difference in the VAS score and ODI between the two groups at 6 and 12 months after surgery (P ＜ 0.05).There was no complication such as dural and nerve injury and internal fixation rupture in the two groups.In the open TLIF group,postoperative wound healing was delayed in two cases,postoperative incision infection occurred in one cases,the incidence of postoperative complication was 11.5％ (3/26).In the MIS-TLIF group no postoperative complication occurred,the incidence of postoperative complication was 0.0％ (0/20);the incidence of postoperative complications was not statistically significant between the two groups (x2 =2.471,P ＜ 0.05).Conclusion MIS-TLIF via Quadrant minimally invasive system has the advantages of less blood loss,incision and volume of drainage after operation in treating lumbar degenerative disease,and it can be used as the first choice for the treatment of lumbar degenerative disease.
ABSTRACT
Objective To observe the clinical therapeutic outcomes and the radiographs changes of lumbar degeneration disease treated by dynamic stabilization device (Wallis). Methods Eighty-four cases of lumbar degeneration disease were treated by threaded fusion cage, from May 1997 to May 2002. The JOA scores, the rate of fusion,cage sink and adjacent segment degeneration were observed. Results The average hospitalizotion was 23.59 days. The mean operation time was 3.00 hours. The mean JOA scores were 13.93 before the operation,while 26.69 on the end of the following time respectively; there was statistical significant. The mean motion of operative segment was 5.22 before operation, while 2.44 on the end of the following time respectively. The mean extension of operative segment was 3.32 before operation ,while 1.39 on the end of the following time respectively. The mean motion of adjacent segment was 3.68 before operation, while 6.54 on the end of the following time respectively. The mean extension of adjacent segment was 1.95 before operation,while 3.95 on the end of the following time respectively. There were all statistical significant on those changes of Cobbs angel. Conclusions The long-term therapeuptic effect of WALLIS treatment for lumbar degeneration disease is reliable. The motion of operative segment was significant decreased, especially on extension. The motion of adjacent segment was significant increased, the degree extension of adjacent segment was also significant increased.