Clinical outcomes of two internal fixation in minimally invasive transforaminal lumbar interbody fusion

English Keywords:Transforaminal lumbar interbody fusion  Surgical procedures  Minimally invasive  Hybrid fixation  Control study

English Abstract:

  【Abstract】 Objectives: To compare the clinical outcomes between hybrid fixation by using pedicle screws plus translaminar screw and normal pedicle screw fixation in minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF) for single-level lumbar disc disease. Methods: From January 2009 to January 2011, 82 patients with single-level disc disease and undergoing MIS-TLIF were divided into two groups: 37 cases in unilateral hybrid fixation group(group A) and 45 cases in bilateral pedicle screw fixation group(group B). Clinical outcomes were assessed in terms of back and leg pain visual analogue scale(VAS), Oswestry disability index(ODI) at 1 day before surgery and 1 day, 3 months, 6 months and 12 months after surgery. The outcomes of operation time, intraoperative blood loss, postoperative bedtime, hospitalization time and fusion rate were compared between two groups. Results: There were no significant differences with respect to age, gender, level of fusion, diseased region and follow-up time between group A and B(P>0.05). Operation time, intraoperative blood loss, length of incision, postoperative ambulation, hospitalization time in group A was (110±24)min, (68±19)ml, (29±3)mm, (23±7)h, (2.9±1.0)d respectively, which in group B was (155±35)min, (96±27)ml, (59±5)mm, (27±9)h, (3.4±1.2)d respectively. There were significant differences between group A and group B(P<0.05). The postoperative VAS and ODI scores at 3, 6 and 12 months of two groups were better than the preoperative outcomes(P<0.05). No difference existed as for the incidence of complications, postoperative leg pain VAS and ODI scores at the same time-point and lumbar fusion between two groups(P>0.05). But the back pain VAS score of group A at postoperative 1 day was lower than that of group B(P<0.05). Conclusions: Both unilateral hybrid fixation by using pedicle screws and translaminar screw and bilateral pedicle screw fixation have comparable good clinical outcomes for MIS-TLIF.