Minimally invasive transforaminal lumbar interbody fusion with unilateral or bilateral pedicle screw fixation for lumbar degenerative diseases

English Keywords:Minimally invasive  TLIF  Spinal fusion  Unilateral pedicle screw fixation

English Abstract:

  【Abstract】 Objectives: To assess the surgical outcomes of minimally invasive transforaminal lumbar interbody fusion(MI-TLIF) with unilateral or bilateral pedicle screw instrumentation for one-level degenerative lumbar spine disease. Methods: Between October 2009 and January 2012, a total of 65 patients underwent 1-level MI-TLIF by one surgeon in our hospital. All patients underwent minimally invasive unilateral decompression, interbody fusion and pedicle screw fixation with the assistance of microscopic tubular retractor system(METRx-MD). 31 patients(17 males and 14 females; average age of 57.3 years) underwent MI-TLIF plus unilateral pedicle screw fixation(group A), while 34 patients(16 males and 18 females; average age of 58.9 years) underwent MI-TLIF plus bilateral pedicle screw fixation(group B). Operation time, blood loss, postoperative hospital duration and complications were evaluated. The Oswestry disability index(ODI) score and visual analog scale(VAS) pain score were obtained for all patients 24 hours before operation and at each follow-up. Results: The mean follow-up was 26.6 months, with a range of 18 to 36 months. All patients showed evidence of fusion at 12 months postoperatively. The average operation time was (101.4±27.2)min for group A and (143.1±22.5)min for group B, the average operative blood loss was (52.5±39.7)ml for group A and (106.3±53.8)ml for group B, the average postoperative hospital duration was 4.4±1.5d for group A and 6.6±2.1d for group B, there was significant difference between 2 groups. The average postoperative VAS and ODI scores improved significantly in each group. No significant differences were found between 2 groups with respect to ODI and VAS scores. Conclusions: One-level unilateral pedicle screw instrumented MIS-TLIF provides similar outcomes to that of bilateral, with shorter operation time, less bleeding and shorter hospital duration.