Effect of MED-TLIF Combined with Percutaneous Pedicle Screw Fixation on Function and Spinal Pelvic Parameters in Patients with Lumbar Spondylolisthesis.

Abstract

Background Lumbar spondylolisthesis is a common clinical spinal lesion. The upper vertebral body of the patient is displaced relative to the lower vertebral body, causing spinal instability and nerve compression. The clinical manifestations are low back and leg pain, abnormal lower limb sensation, and intermittent rupture. In severe cases, cauda equina syndrome and paraplegia may occur. Minimally invasive spinal surgery has developed rapidly in recent years and become the preferred treatment for lumbar spondylolisthesis. Objective The aim of this study is to investigate the clinical effect of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) combined with percutaneous pedicle screw fixation in the treatment of lumbar spondylolisthesis under microscope. Methods The clinical and surgical data of 106 patients with lumbar spondylolisthesis treated in our hospital were selected and divided into research group (56 cases) according to surgical methods (MIS-TLIF combined with percutaneous pedicle screw fixation). The other 50 patients were treated with traditional open percutaneous intervertebral foramen fusion (control group). The surgical trauma-related indicators, visual analog pain scale (VAS) scores before and after surgery, modified Japanese Orthopedic Association low back pain score (JOA), bone graft fusion effect, spinal pelvic parameters, and surgical complications of the two groups were statistically analyzed in detail. Results The incision length, intraoperative blood loss, operation time, and hospitalization time in the research group were lower than those in the control group, and the differences were statistically significant (P < 0.05). There was no significant difference in the VAS score and JOA score between the two groups before operation (P > 0.05). The VAS score and JOA score of the research group were lower than those of the control group on the first day after operation (P < 0.05). There was no significant difference in the VAS score and JOA score between the two groups at 1 month and 3 months after operation (P > 0.05). Six months, 12 months, and 18 months after operation, the bone graft fusion rates in the research group were 42.86%, 73.21%, and 94.64%, respectively, and those in the control group were 40.00%, 68.00%, and 92.00%, respectively, with no significant difference (P > 0.05). There was no significant difference in PI, PT, SS, LL, TK, LSJA, and SVA between the two groups before and 6 months after operation (P > 0.05). At 6 months after operation, the PT and TK values of the two groups were higher than those before operation (P < 0.05), and the SS, LL, LSJA, and SVA values of the two groups were lower than those before operation (P < 0.05). The complication rate of the research group was 3.57%, which was lower than 18.00% of the control group, and the difference was statistically significant (P < 0.05). Conclusion MIS-TLIF combined with percutaneous pedicle screw fixation in the treatment of lumbar spondylolisthesis has the same effect as traditional open surgery and has the same correction effect for spinal pelvic parameters, but it has the advantages of less trauma and fewer complications.