Comparative Efficacy of Three Methods of Lumbar Interbody Fusion for Lumbar Degenerative Diseases in a Tertiary Public Hospital.

Abstract

To evaluate the clinical efficacy of large-channel endoscope-assisted posterior lumbar interbody fusion (Endo-PLIF), minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), and open posterior lumbar interbody fusion in the treatment of degenerative diseases of the lumbar spine. The data of 110 patients with degenerative diseases of the lumbar spine were analyzed retrospectively: 31 cases had Endo-PLIF, 36 patients received MIS-TLIF, and 43 cases underwent modified-TLIF. We compared several parameters among the three groups: operative duration; intraoperative blood loss; latent blood loss; intraoperative radiation dose; visual analog scale (VAS) score; Oswestry Disability Index (ODI); anterior protrusion angle of the intervertebral space; postoperative ambulatory time; postoperative duration of hospital stay; complications. The prevalence of interbody fusion was observed at follow-up. The operative duration of Endo-PLIF was longer than that of MIS-TLIF and modified-TLIF (P <0.05). In terms of intraoperative blood loss, latent blood loss, and recovery time, Endo-PLIF and MIS-TLIF had clear advantages (P <0.05). The VAS score and ODI of the three groups were satisfactory, but the low-back pain of patients in the Endo-PLIF group and MIS-TLIF group was less than that in the modified-TLIF group (P <0.05). In terms of complications and prevalence of interbody fusion, there were no significant differences among the three groups (P >0.05). All three operative methods had satisfactory efficacy. Endo-PLIF can be employed to treat lumbar degenerative diseases more precisely and in a minimally invasive fashion, but a learning curve and improvement in surgical instruments are needed.