Minimal Invasive Unilateral Transforaminal Lumbar Interbody Fusion by Sublaminar Decompression: Comparison to Bilateral Approach / 대한정형외과학회잡지

ABSTRACT

PURPOSE: This is a comparison of the unilateral and bilateral approaches for minimal invasive transforaminal lumbar interbody fusion (TLIF), and we did so by measuring the clinical and radiological results. MATERIALS AND METHODS: This study examined a consecutive series of 47 patients who underwent one-level TLIF (26 cases of the unilateral approach and 21 cases of the bilateral approach to the lumbar spine) and the follow-up data was compared with a minimum 1-year follow-up. Sublaminar decompression and contralateral foraminectomy were done in all the case of using the unilateral approach. The age of each patient, the amount of intraoperative blood loss, the postoperative drainage, the transfusion requirement and the surgery time were investigated. The clinical outcomes were analyzed using the visual analogue scale, the SF-36 Physical Composite Score (PCS) and the Oswestry disability index (ODI). The preoperative, postoperative & last follow-up changes in the height and angles of the disc in the fused segments and the lumbar lordotic angles were radiologically analyzed. RESULTS: There was no statistical difference between the two groups in terms of the clinical and radiographic results at the last follow-up. But the unilateral approach-group was found to have a less blood loss, less postoperative drainage, a lesser requirement for transfusion and a shorter surgery time. CONCLUSION: This study confirms that the unilateral approach can be the better way if the technical problems are solved.