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Research article
Yong-Xin Ren
Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital
Corresponding Author
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Background: There are currently several minimally invasive techniques for lumbar spine interbody fusion that have been shown to minimize surgical and perioperative morbidity. We aimed to evaluate the curative efficacy of endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) by comparing perioperative characteristics and 1.5-year observational outcomes in 1-segment lumbar spondylolisthesis between the minimally invasive TLIF (MIS-TLIF) technique and the optimized Endo-TLIF technique.
Methods: One hundred and two patients treated by MIS-TLIF (48 cases) or Endo-TLIF (54 cases) were included from March 2018 to April 2019. Perioperative parameters and clinical outcomes were evaluated. Inflammatory biomarkers were measured for postoperative traumatic stress and muscle injury. Fusion rates were determined at 18 months after surgery by CT.
Results: The Endo-TLIF group had similar incision length, return to work time and rate (p>0.05). Blood loss, left bed time and analgesic ratio were significantly less in Endo-TLIF group (p<0.05). The Endo-TLIF group had a significantly longer operative and radiation exposure time compared with MIS-TLIF group (p<0.05). The CRP and ESR levels were lower in the Endo-TLIF group compared with the MIS-TLIF group (p<0.05). The VAS and ODI improved significantly in both groups after surgery. Significant decreases in low back VAS in the Endo-TLIF group were found at postoperative day 1 and 3 months after surgery (p<0.05). The fusion rate in the Endo-TLIF group (90.7%) was similar to that in the MIS-TLIF group (95.8%).
Conclusions: Endo-TLIF has comparable perioperative analysis and clinical outcomes in comparison to MIS-TLIF and manifests a greater improvement in less multifidus muscle damage, inflammation and faster patient recovery. Thus, Endo-TLIF should be considered as a feasible and effective technique for 1-segment lumbar spondylolisthesis patients with similar fusion rate.
Trial registration: ChiCTR1800015197, 13 March 2018. Trial registry: Chinese Clinical Trial Registry. Registered 13 March 2018. http://www.chictr.org.cn/showproj.aspx?proj=25865
Keywords
minimally invasive, endoscopy, spondylolisthesis, interbody fusion, bone morphogenetic protein
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research article
Yong-Xin Ren
Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 2
Posted 28 May, 2021
No community comments so far
No comments provided
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: There are currently several minimally invasive techniques for lumbar spine interbody fusion that have been shown to minimize surgical and perioperative morbidity. We aimed to evaluate the curative efficacy of endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) by comparing perioperative characteristics and 1.5-year observational outcomes in 1-segment lumbar spondylolisthesis between the minimally invasive TLIF (MIS-TLIF) technique and the optimized Endo-TLIF technique.
Methods: One hundred and two patients treated by MIS-TLIF (48 cases) or Endo-TLIF (54 cases) were included from March 2018 to April 2019. Perioperative parameters and clinical outcomes were evaluated. Inflammatory biomarkers were measured for postoperative traumatic stress and muscle injury. Fusion rates were determined at 18 months after surgery by CT.
Results: The Endo-TLIF group had similar incision length, return to work time and rate (p>0.05). Blood loss, left bed time and analgesic ratio were significantly less in Endo-TLIF group (p<0.05). The Endo-TLIF group had a significantly longer operative and radiation exposure time compared with MIS-TLIF group (p<0.05). The CRP and ESR levels were lower in the Endo-TLIF group compared with the MIS-TLIF group (p<0.05). The VAS and ODI improved significantly in both groups after surgery. Significant decreases in low back VAS in the Endo-TLIF group were found at postoperative day 1 and 3 months after surgery (p<0.05). The fusion rate in the Endo-TLIF group (90.7%) was similar to that in the MIS-TLIF group (95.8%).
Conclusions: Endo-TLIF has comparable perioperative analysis and clinical outcomes in comparison to MIS-TLIF and manifests a greater improvement in less multifidus muscle damage, inflammation and faster patient recovery. Thus, Endo-TLIF should be considered as a feasible and effective technique for 1-segment lumbar spondylolisthesis patients with similar fusion rate.
Trial registration: ChiCTR1800015197, 13 March 2018. Trial registry: Chinese Clinical Trial Registry. Registered 13 March 2018. http://www.chictr.org.cn/showproj.aspx?proj=25865
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
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