Comparison of minimally invasive fusion and instrumentation versus open surgery for severe stenotic spondylolisthesis with high-grade facet joint osteoarthritis

被引:75
作者
Archavlis, Eleftherios [1 ]
Carvi y Nievas, Mario [2 ]
机构
[1] Goethe Univ Frankfurt, Dept Neurosurg, Klinikum Offenbach, Akad Lehrkrankenhaus, D-63069 Offenbach, Germany
[2] Univ Munich, Dept Neurosurg, Klinikum Traunstein, Akad Lehrkrankenhaus, Traunstein, Germany
关键词
Minimally invasive transforaminal interbody fusion; Spondylolisthesis; Lumbar stenosis; Facet joint osteoarthritis; LUMBAR INTERBODY FUSION; SURGICAL OUTCOMES; SPINE SURGERY; COMPLICATIONS; ACCURACY; TLIF;
D O I
10.1007/s00586-013-2732-6
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The object of this study was to compare minimally invasive surgery (MIS) with open surgery in a severely affected subgroup of degenerative spondylolisthetic patients with severe stenosis (SDS) and high-grade facet osteoarthritis (FJO). From January 2009 to February 2010, 49 patients with severe SDS and high-grade FJO were treated using either MIS or open TLIF. Intraoperative and diagnostic data, including perioperative complications and length of hospital stay (LOS), were collected, using retrospective chart review. Surgical short- and long-term outcomes were assessed according to the Oswestry disability index (ODI) and visual analog scale (VAS) for back and leg pain. Comparing MIS and open surgery, the MIS group had lesser blood loss, significantly lesser need for transfusion (p = 0.02), more rapid improvement of postoperative back pain in the first 6 weeks of follow-up and a shorter LOS. On the other hand, we experienced in the MIS group a longer operative time. The distribution on the postoperative ODI (p = 0.841), VAS leg (p = 0.943) and back pain (p = 0.735) scores after a mean follow-up of 2 years were similar. The overall proportion of complications showed no significant difference between the groups (29 % in the MIS group vs. 28 % in the open group, p = 0.999). Minimally invasive surgery for severe SDS leads to adequate and safe decompression of lumbar stenosis and results in a faster recovery of symptoms and disability in the early postoperative period.
引用
收藏
页码:1731 / 1740
页数:10
相关论文
共 29 条
  • [1] Clinical and radiographic comparison of mini-open transforaminal lumbar interbody fusion with open transforaminal lumbar interbody fusion in 42 patients with long-term follow-up
    Dhall, Sanjay S.
    Wang, Michael Y.
    Mummaneni, Praveen V.
    [J]. JOURNAL OF NEUROSURGERY-SPINE, 2008, 9 (06) : 560 - 565
  • [2] Prospective analysis of surgical outcomes in patients undergoing decompressive laminectomy and posterior instrumentation for degenerative lumbar spinal stenosis
    Gelalis, Ioannis D.
    Arnaoutoglou, Christina
    Christoforou, Giorgos
    Lykissas, Marios G.
    Batsilas, Ioannis
    Xenakis, Theodoros
    [J]. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA, 2010, 44 (03) : 235 - 240
  • [3] Holly Langston T, 2006, Neurosurg Focus, V20, pE6
  • [4] Maximizing the potential of minimally invasive spine surgery in complex spinal disorders
    Hsieh, Patrick C.
    Koski, Tyler R.
    Sciubba, Daniel M.
    Moller, Dave J.
    O'Shaughnessy, Brian A.
    Li, Khan W.
    Gokaslan, Ziya L.
    Ondra, Stephen L.
    Fessler, Richard G.
    Liu, John C.
    [J]. NEUROSURGICAL FOCUS, 2008, 25 (02)
  • [5] A minimally invasive posterior lumbar interbody fusion for degenerative lumbar spine instabilities
    Logroscino, C. A.
    Proietti, L.
    Pola, E.
    Scaramuzzo, L.
    Tamburrelli, F. C.
    [J]. EUROPEAN SPINE JOURNAL, 2011, 20 : 41 - 45
  • [6] Unilateral transforaminal posterior lumbar interbody fusion (TLIF): Indications, technique, and 2-year results
    Lowe, TG
    Tahernia, AD
    O'Brien, MF
    Smith, DAB
    [J]. JOURNAL OF SPINAL DISORDERS & TECHNIQUES, 2002, 15 (01): : 31 - 38
  • [7] THE MINI-OPEN TRANSFORAMINAL LUMBAR INTERBODY FUSION
    Mummaneni, Praveen V.
    Rodts, Gerald E., Jr.
    [J]. NEUROSURGERY, 2005, 57 (04) : 256 - 261
  • [8] Minimally invasive spine technology and minimally invasive spine surgery: a historical review
    Oppenheimer, Jeffrey H.
    DeCastro, Igor
    McDonnell, Dennis E.
    [J]. NEUROSURGICAL FOCUS, 2009, 27 (03) : E9.1 - E9.15
  • [9] Minimally invasive transforaminal lumbar interbody fusion with reduction of spondylolisthesis: technique and outcomes after a minimum of 2 years' follow-up
    Park, Paul
    Foley, Kevin T.
    [J]. NEUROSURGICAL FOCUS, 2008, 25 (02)
  • [10] Surgical Outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion for the Treatment of Spondylolisthesis and Degenerative Segmental Instability
    Park, Yung
    Ha, Joong Won
    Lee, Yun Tae
    Oh, Hyun Chul
    Yoo, Ju Hyung
    Kim, Hyung Bok
    [J]. ASIAN SPINE JOURNAL, 2011, 5 (04) : 228 - 236