Minimally invasive transforaminal lumbar interbody fusion for treatment of single-segment lumbar spinal stenosis improves lumbar-pelvic balance / 中国组织工程研究

ABSTRACT

BACKGROUND: More and more studies have shown that lumbar-pelvic parameters are closely related to the clinical effect and adjacent segment degeneration after lumbar fusion, but the effect of minimally invasive transforaminal interbody fusion on lumbar-pelvic parameters is not clear. OBJECTIVE: To evaluate the effect of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) on the lumbar-pelvic imaging parameters in patients with single-segment lumbar spinal stenosis. METHODS: The clinical data of 85 patients with single-segment lumbar spinal stenosis treated by MIS-TLIF and open-TLIF in the First Affiliated Hospital of Dali University from January 2015 to January 2017 were retrospectively analyzed, including 39 cases of MIS-TLIF operation (MIS-TLIF group) and 46 cases of open-TLIF operation (open-TLIF group). On the standing lateral lumbar X-ray containing bilateral femoral heads lumbar lordosis, segmental lordosis, height of the intervertebral disc, the L1 axis and S1 distance, pelvic incidence, pelvic tilt, and sacral slope were measured, and the difference between pelvic incidence−lumbar lordosis and the ratio of lumbar lordosis/pelvic incidence were calculated. RESULTS AND CONCLUSION: (1) During the last follow-up, lumbar lordosis, height of the intervertebral disc, and sacral slope were increased in both groups compared with preoperative parameters, but pelvic tilt was decreased compared with preoperatively, and the difference was significant (P 0.05). (2) During the last follow-up, lumbar lordosis, segmental lordosis, height of the intervertebral disc, pelvic incidence, pelvic tilt, sacral slope, and the L1 axis and S1 distance were not significantly different compared with preoperative parameters (P > 0.05). (3) The difference between pelvic incidence−lumbar lordosis was significantly decreased at the last follow-up compared with preoperative parameters in the two groups (P 0.05). (4) Above results indicated that for single-segment lumbar spinal stenosis, MIS-TLIF has the same effect as open-TLIF in recovery of lumbar lordosis, intervertebral height, and improving lumbar-pelvic balance.