The clinic study of minimally invasive lumbar interbody fusion for treatment of lumbar spinal stenosis with degenerative lumbar scoliosis

Abstract

Objective To discuss the procedures and therapeutic effects of minimally invasive-transforaminal lumbar interbody fusion (MIS-TLIF) via the X-tube retractor for lumbar spinal stenosis(LSS) with degenerative lumbar scoliosis (DLS). Methods The authors retrospectively reviewed 25 cases of LSS with DLS (grade Ⅱ~Ⅳ according to Lenke-Silva grading standard) who were admitted from January 2012 to January 2016 and treated by MIS-TLIF at Department of Neurosurgery, Xuanwu Hospital, Capital Medical University. Surgical outcomes were evaluated by using the tools including the visual analogue scale (VAS), Oswestry disability index (ODI), short form health survey-36 (SF-36) and imaging examinations. Our follow-up study lasted 6~34 months with an average of 23 months. Results Decompression and interbody fusion were performed in 25 patients and 85 levels. All patients were successfully followed-up. Clinical symptoms completely disappeared in 20 cases and significant improvement were achieved in the remaining 5 cases. The interbody fusion rate was 91% with satisfactory placement of screws. No death or severe complications occurred in this study such as neurological function defect, infection and cerebrospinal fluid leakage. There was no failure of internal fixation, pedicle screw or rod breakage, or cage displacement. Conclusion MIS-TLIF is an effective procedure for the treatment of LSS with DLS and has the advantages including less injury, less blood loss and low complication rate. Key words: Spinal stenosis; Lumbar vertebrae; Scoliosis; Surgical procedures, minimally invasive