Postoperative clinical outcome in patients have lumbar disk herniation with spinal stenosis by transpedicular screw fixation and transforaminal intervertebral fusion (minimally invasive and open surgery)

Kiều Đình Hùng, Sơn Bùi

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Abstract

The minimally invasive TLIF (MI-TLIF) Surgery is increasingly used for treating herniated lumbar disk diseases with spinal stenosis. The objective of our study was to evaluate the clinical outcome of minimally invasive surgery (MIS) versus open techniques for transforaminal lumbar interbody fusion (TLIF). A Retrospective description study was applied from January 2020 to December 2020, over 83 patients treated surgically at Hanoi Medical University Hospital. The average age was 49.31 ± 12.83 years old, gender rate Male/Female is 1.01/1. Compared to patients in the Open group, patients in the Mis group had significantly less intraoperative hemorrhage, shorter hospital stay after surgery (p < 0.05) and shorter operation times. In addition, the postoperative back pain at 6 months after surgery in the Mis group were remarkably lower than those in the Open group. The postoperative leg pain, Oswestry disability index (ODI) are lower in the MIS-TLIF group but there was no significant difference. MIS-TLIF is safe and provides more benefits in patients with lumbar disc herniation compared to Open-TLIF.

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References

1. Yelin E. Cost of musculoskeletal diseases: impact of work disability and functional decline. J Rheumatol Suppl. 2003; 68:8-11.
2. Yang LH, Liu W, Li J, et al. Lumbar decompression and lumbar interbody fusion in the treatment of lumbar spinal stenosis. Medicine (Baltimore). 2020; 99(27):e20323. doi:10.1097/MD.0000000000020323.
3. Hu W, Tang J, Wu X, Zhang L, Ke B. Minimally invasive versus open transforaminal lumbar fusion: a systematic review of complications. Int Orthop. 2016; 40(9):1883-1890. doi:10.1007/s00264-016-3153-z.
4. Mobbs RJ, Phan K, Malham G, Seex K, Rao PJ. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF. J Spine Surg. 2015;1(1):2-18. doi:10.3978/j.issn.2414-469X.2015.10.05.
5. Goldstein CL, Phillips FM, Rampersaud YR. Comparative Effectiveness and Economic Evaluations of Open Versus Minimally Invasive Posterior or Transforaminal Lumbar Interbody Fusion: A Systematic Review. Spine. 2016;41 Suppl 8:S74-89. doi:10.1097/BRS.0000000000001462
6. Liang Y, Shi W, Jiang C, et al. Clinical outcomes and sagittal alignment of single-level unilateral instrumented transforaminal lumbar interbody fusion with a 4 to 5-year follow-up. Eur Spine J. 2015;24(11):2560-2566. doi:10.1007/s00586-015-3933-y.
7. Foley KT, Gupta SK. Percutaneous pedicle screw fixation of the lumbar spine: preliminary clinical results. J Neurosurg. 2002;97(1 Suppl):7-12. doi:10.3171/spi.2002.97.1.0007.
8. Price JP, Dawson JM, Schwender JD, Schellhas KP. Clinical and Radiologic Comparison of Minimally Invasive Surgery With Traditional Open Transforaminal Lumbar Interbody Fusion: A Review of 452 Patients From a Single Center. Clin Spine Surg. 2018; 31(2):E121-E126. doi:10.1097/BSD.0000000000000581.
9. Rosenberg WS, Mummaneni PV. Transforaminal lumbar interbody fusion: technique, complications, and early results. Neurosurgery. 2001; 48(3):569-574; discussion 574-575. doi:10.1097/00006123-200103000-00022.
10. Gertzbein SD, Robbins SE. Accuracy of pedicular screw placement in vivo. Spine. 1990; 15(1):11-14. doi:10.1097/00007632-199001000-00004.
11. Zhao J, Zhang S, Li X, He B, Ou Y, Jiang D. Comparison of Minimally Invasive and Open Transforaminal Lumbar Interbody Fusion for Lumbar Disc Herniation: A Retrospective Cohort Study. Med Sci Monit Int Med J Exp Clin Res. 2018;24:8693-8698. doi:10.12659/MSM.912808.
12. Peng B, Wu W, Hou S, Li P, Zhang C, Yang Y. The pathogenesis of discogenic low back pain. J Bone Joint Surg Br. 2005; 87(1):62-67.
13. Parke W, Bono C, Garfin S. Applied Anatomy of the Spine. Rothman-Simeone Spine Ed 6. 2011; 1:15-53. doi:10.1016/B978-1-4160-6726-9.00002-X.
14. Kjell Olmarker, MD, PhD, Björn Rydevik, MD, PhD, Shinichi Kikuchi, MD, PhD,. Sciatica and Nerve Root Pain in Disc Herniation and Spinal Stenosis: A Basic Science Review and Clinical Perspective. Musculoskelet Key. July 2016. https://musculoskeletalkey.com/sciatica-and-nerve-root-pain-in-disc-herniation-and-spinal-stenosis-a-basic-science-review-and-clinical-perspective/. Accessed July 11, 2021.
15. Gaines RW. The use of pedicle-screw internal fixation for the operative treatment of spinal disorders. J Bone Joint Surg Am. 2000; 82(10):1458-1476. doi:10.2106/00004623-200010000-00013.
16. Vũ N. Nghiên cứu điều trị trượt đốt sống thắt lưng bằng phương pháp cố định cột sống qua cuống kết hợp hàn xương liên thân đốt. Luận Văn Tiến Sĩ Học. 2015;Trường đại học Y Hà Nội.
17. Ferrick MR, Kowalski JM, Simmons ED. Reliability of roentgenogram evaluation of pedicle screw position. Spine. 1997;22(11):1249-1252; discussion 1253. doi:10.1097/00007632-199706010-00016.
18. Wong AP, Smith ZA, Stadler JA, et al. Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF): surgical technique, long-term 4-year prospective outcomes, and complications compared with an open TLIF cohort. Neurosurg Clin N Am. 2014;25(2):279-304. doi:10.1016/j.nec.2013.12.007.