The clinical effect of Wiltse approach transforaminai lumbar interbody fusion in treatment of lumbar spinal canal stenosis / 中国医师进修杂志

ABSTRACT

Objective To compare the curative effect of transforaminal lumbar interbody fusion by Wihse approach and posterior median approach in treatment of lumbar spinal canal stenosis.Methods Ninety-six patients with lumbar spinal canal stenosis were treated with transforaminal lumbar interbody fusion by Wihse approach (42 cases,Wihse group) and posterior median approach (54 cases,control group).The operation time,exposure time,exposure bleeding volume,length of incision,intraoperative bleeding volume,visual analog score (VAS) of nick at the third day after surgery,and VAS of lumbar and leg,Japanese orthopedic association (JOA) score and Roland-Morris disability questionnaire (RDQ) score at 1 year after surgery were compared between the 2 groups.Results The length of incision,exposure time,operation time,exposure bleeding volume,intraoperative bleeding volume,VAS of nick at the third day after surgery and VAS of lumbar at 1 year after surgery in Wiltse group were (5.0 ± 1.2) cm,(20.0 ± 7.6) min,(150.0 ± 8.4) min,(10.6 ±5.4) ml,(125.5 ± 10.6) ml,(4.5 ±0.6) scores and (1.0 ±0.5) scores,and in control group were (8.0 ± 1.6) cm,(35.2 ±6.8) min,(162.0 ±5.6) min,(84.5 ±7.8) ml,(186.4 ± 15.4) ml,(6.8 ± 0.5) scores and (2.5 ± 0.8) scores],there were statistical differences between the 2 groups (P ＜ 0.01).But there were no statistical differences in the VAS of leg,JOA score and RDQ score at 1 year after surgery between the 2 groups (P ＞ 0.05).Conclusion Two kinds of approach transforaminal lumbar interbody fusions all have good therapeutic effect on lumbar spinal canal stenosis,but the Wiltse approach has advantages of small incision,less intraoperative dissection,less bleeding and low incidence of postoperative lumbodynia.