Navigation-assisted minimally invasive transforaminal lumbar interbody fusion versus traditional fluoroscopy-assisted open transforaminal lumbar interbody fusion for adult lumbar spondylolisthesis——a randomized controlled trial

Abstract

Objective To compare the clinical outcomes of navigation-assisted minimally invasive transforaminal lumbar interbody fusion (TLIF) with traditional fluoroscopy-assisted open TLIF.Methods Between May 2011 and March 2013,27 eligible adult patients with lumbar spondylolisthesis were randomly assigned to receive navigation-assisted minimally invasive TLIF (13 cases) or traditional fluoroscopy-assisted open TLIF (14 cases).The 2 groups were compatible with no significant differences in preoperative general data (P ＞ 0.05).The 2 groups were compared in terms of operation time,intraoperative blood loss,hospital stay,post-operative Japanese Orthopaedic Association (JOA)score,Oswestry disability Index (ODI)score,visual analogue scale (VAS) score,Odom' s evaluation,and rates of good to excellent pedicle insertion,olisthe,reduction and fusion.Results The navigation-assisted TLIF and traditional TLIF groups were followed up respectively for 12.4 and 11.5 months on average.The navigation-assisted minimally invasive TLIF group had significantly less blood loss,greater JOA improvement and lower ODI scores than the traditional open TLIF group (P ＜ 0.05).There were no significant differences between the 2 groups regarding operation time,hospital stay,VAS score,Odom's evaluation,or rates of good to excellent pedicle insertion,olisthe,reduction and fusion (P ＞ 0.05).Conclusion Since navigation-assisted minimally invasive TLIF has advantages of decreased intraoperative blood loss,minimal invasion and accurate pedicle insertion compared with traditional open TLIF,it has a promising prospect of clinical application. Key words: Lumbar vertebrae; Surgery, computer-assisted; Surgical procedures, minimally; Spondylolysis