Observation of the perioperative period of lumbar degenerative disease treated by microscope-assisted minimally invasive transforaminal lumbar interbody fusion combined with pedicle screw internal fixation

Abstract

Objective To evaluate the early clinical curative effect of microscope-assisted minimally invasive transforaminal lumbar interbody fusion(MI-TLIF) combined with contralateral percutaneous pedicle screw fixation for lumbar degenerative disease. Methods The clinical data of 60 cases with single-level lumbar degenerative disease treated who were admitted to the Departement of Spine Surgery of Tengzhou Central People's Hospital from January 2012 to January 2015 were analyzed retrospectively. The patients were treated with microscope-assisted MI-TLIF combined with contralateral percutaneous pedicle screw fixation(minimally invasive group, 29 cases) and traditional posterior lumbar interbody fusion(traditional group, 31 cases), respectively. A retrospective study was performed to compare the duration of surgery, intraoperative blood loss, postoperative drainage, C-reactive protein(CRP) and creatine kinase(CK). Visual analogy score(VAS) were used for the evaluation of postoperative pain. Average hospitalization days and time of ambulation were also recorded and compared between the two groups. Oswestry disability index(ODI) performed preoperatively and at the first and the third months postoperatively were analyzed for clinical assessment. Results There were no significant differences in preoperative CRP, CK, ODI and the duration of surgery between the two groups(all P values>0.05). The minimally invasive group had less blood loss, lower postoperative drainage, lower VAS at postoperative 1 d, 3 d, 5 d, lower CRP level and lower CK level at postoperative 1 d than traditional group(all P values 0.05). Conclusions MI-TLIF combined with contralateral percutaneous pedicle screw fixation for lumbar degenerative disease not only has no significant differences in the neurologic function recovery, but also has the advantages of less bleeding, mild pain, rapid recovery and minimal surgical trauma. Key words: Microsurgery; Diskectomy; Percutaneous; Intervertebral disc degeneration; Lumbar vertebrae; Internal fixators