Comparison of the therapeutic effect of minimally invasive transforaminal lumbar interbody fusion and posterior lumbar interbody fusion in the treatment of single-level lumbar disc herniation / 中国基层医药

ABSTRACT

Objective:To compare the efficacy of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and posterior lumbar interbody fusion (PLIF) in the treatment of single-level lumbar disc herniation, and its influence on inflammatory factors in peripheral blood.Methods:From July 2016 to July 2018, 100 patients with single-level lumbar disc herniation admitted to the People's Hospital of Haiyan County were selected and divided into observation group ( n=50) and control group ( n=50) according to random number table method.The patients in the control group were treated with PLIF, while the patients in the observation group were treated with MIS-TLIF.The visual analogue scale (VAS), Oswestry dysfunction index (ODI) scores and the levels of inflammatory factors in peripheral blood were compared between the two groups before and after operation.The recurrence rate, incidence of complication and surgical indicators were observed. Results:The VAS and ODI scores at postoperative 1 week in the observation group were (2.32±0.85)points and (19.46±3.44)points, respectively, which were lower than those in the control group[(4.41±0.97)points and (25.78±3.63)points], the differences were statistically significant( t=13.485, 8.936, all P<0.05). The tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) levels in the observation group at postoperative 1 week were (2.76±0.49)ng/L and (0.78±0.13)ng/L, respectively, which were lower than those in the control group[(4.68±0.81)ng/L and (1.12±0.17)ng/L], the differences were statistically significant ( t=14.341, 11.240, all P<0.05). The operation time and bed-rest time in the observation group were (109.53±20.37)min and (30.61±3.30)d, respectively, which were shorter than those in the control group[(122.34±30.21)min and (42.87±4.68)d], and the intraoperative blood loss and postoperative drainage volume in the observation group were (181.12±40.86)mL and (60.08±11.62)mL, respectively, which were lower than those in the control group[(306.65±50.38)mL and (218.41±24.46)mL], the differences were statistically significant between the tuo groups ( t=2.486, 15.139, 13.684, 41.343, all P<0.05). The incidence of complications in the observation group was 8.00%(4/50), which was lower than 30.00%(15/50) in the control group (χ 2=19.512, P<0.05). At 3, 6 and 9 months after operation, the recurrence rates in the observation group were 0.00%, 4.00% and 8.00%, respectively, which were lower than 6.00%, 10.00% and 22.00% in the control group(χ 2=6.186, 5.674, 7.686, all P<0.05). Conclusion:Compared with PLIF, MIS-TLIF can achieve good results in the treatment of single-level lumbar disc herniation, which can relieve patients' pain, promote the recovery of waist function, reduce inflammatory response, and reduce the recurrence rate and incidence of complications.