Minimally Invasive Transforaminal Lumbar Interbody Fusion for Spondylolisthesis and Degenerative Spondylosis: 5-year Results

被引:40
作者
Park, Yung [1 ]
Ha, Joong Won [1 ]
Lee, Yun Tae [1 ]
Sung, Na Young [1 ]
机构
[1] Yonsei Univ, Coll Med, Natl Hlth Insurance Serv, Dept Orthoped Surg,Ilsan Hosp, Goyang City 410719, Gyeonggi Provin, South Korea
关键词
SPINAL STENOSIS; CLINICAL-OUTCOMES; LONG-TERM; COMPLICATIONS; MINIMUM;
D O I
10.1007/s11999-013-3241-y
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Multiple studies have reported favorable short-term results after treatment of spondylolisthesis and other degenerative lumbar diseases with minimally invasive transforaminal lumbar interbody fusion. However, to our knowledge, results at a minimum of 5 years have not been reported. We determined (1) changes to the Oswestry Disability Index, (2) frequency of radiographic fusion, (3) complications and reoperations, and (4) the learning curve associated with minimally invasive transforaminal lumbar interbody fusion at minimum 5-year followup. We reviewed our first 124 patients who underwent minimally invasive transforaminal lumbar interbody fusion to treat low-grade spondylolisthesis and degenerative lumbar diseases and did not need a major deformity correction. This represented 63% (124 of 198) of the transforaminal lumbar interbody fusion procedures we performed for those indications during the study period (2003-2007). Eighty-three (67%) patients had complete 5-year followup. Plain radiographs and CT scans were evaluated by two reviewers. Trends of surgical time, blood loss, and hospital stay over time were examined by logarithmic curve fit-regression analysis to evaluate the learning curve. At 5 years, mean Oswestry Disability Index improved from 60 points preoperatively to 24 points and 79 of 83 patients (95%) had improvement of greater than 10 points. At 5 years, 67 of 83 (81%) achieved radiographic fusion, including 64 of 72 patients (89%) who had single-level surgery. Perioperative complications occurred in 11 of 124 patients (9%), and another surgical procedure was performed in eight of 124 patients (6.5%) involving the index level and seven of 124 patients (5.6%) at adjacent levels. There were slowly decreasing trends of surgical time and hospital stay only in single-level surgery and almost no change in intraoperative blood loss over time, suggesting a challenging learning curve. Oswestry Disability Index scores improved for patients with spondylolisthesis and degenerative lumbar diseases treated with minimally invasive transforaminal lumbar interbody fusion at minimum 5-year followup. We suggest this procedure is reasonable for properly selected patients with these indications; however, traditional approaches should still be performed for patients with high-grade spondylolisthesis, patients with a severely collapsed disc space and no motion seen on the dynamic radiographs, patients who need multilevel decompression and arthrodesis, and patients with kyphoscoliosis needing correction. Level IV, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.
引用
收藏
页码:1813 / 1823
页数:11
相关论文
共 50 条
[31]   Minimally invasive versus traditional open transforaminal lumbar interbody fusion for the treatment of low-grade degenerative spondylolisthesis: a retrospective study [J].
Qin, Rongqing ;
Wu, Tong ;
Liu, Hongpeng ;
Zhou, Bing ;
Zhou, Pin ;
Zhang, Xing .
SCIENTIFIC REPORTS, 2020, 10 (01)
[32]   Comparison of 270-degree percutaneous transforaminal endoscopic decompression under local anesthesia and minimally invasive transforaminal lumbar interbody fusion in the treatment of geriatric lateral recess stenosis associated with degenerative lumbar spondylolisthesis [J].
Li, Yubo ;
Cheng, Xiaokang ;
Chen, Bin .
JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH, 2023, 18 (01)
[33]   Patient-reported and radiographic outcomes of minimally invasive transforaminal lumbar interbody fusion for degenerative spondylolisthesis with or without reduction: A comparative study [J].
Fan, Guoxin ;
Zhang, Hailong ;
Guan, Xiaofei ;
Gu, Guangfei ;
Wu, Xinbo ;
Hu, Annan ;
Gu, Xin ;
He, Shisheng .
JOURNAL OF CLINICAL NEUROSCIENCE, 2016, 33 :111-118
[34]   Minimally Invasive Transforaminal Lumbar Interbody Fusion in the Outpatient Setting [J].
Emami, Arash ;
Faloon, Michael ;
Issa, Kimona ;
Shafa, Eiman ;
Pourtaheri, Sina ;
Sinha, Kumar ;
Hwang, Ki S. .
ORTHOPEDICS, 2016, 39 (06) :E1218-E1222
[35]   Minimally invasive versus open transforaminal lumbar interbody fusion for grade I lumbar spondylolisthesis: 5-year follow-up from the prospective multicenter Quality Outcomes Database registry [J].
Chan, Andrew K. ;
Bydon, Mohamad ;
Bisson, Erica F. ;
Glassman, Steven D. ;
Foley, Kevin T. ;
Shaffrey, Christopher, I ;
Potts, Eric A. ;
Shaffrey, Mark E. ;
Coric, Domagoj ;
Knightly, John J. ;
Park, Paul ;
Wang, Michael Y. ;
Fu, Kai-Ming ;
Slotkin, Jonathan R. ;
Asher, Anthony L. ;
Virk, Michael S. ;
Michalopoulos, Giorgos D. ;
Guan, Jian ;
Haid, Regis W. ;
Agarwal, Nitin ;
Park, Christine ;
Chou, Dean ;
Mummaneni, Praveen, V .
NEUROSURGICAL FOCUS, 2023, 54 (01)
[36]   Minimally invasive transforaminal lumbar interbody fusion versus open transforaminal lumbar interbody fusion: a technical description and review of the literature [J].
Vazan, Martin ;
Gempt, Jens ;
Meyer, Bernhard ;
Buchmann, Niels ;
Ryang, Yu-Mi .
ACTA NEUROCHIRURGICA, 2017, 159 (06) :1137-1146
[37]   Comparison of Outcomes Between Endoscopic Transforaminal Lumbar Interbody Fusion and Minimally Invasive Transforaminal Lumbar Interbody Fusion in Patients With Single-Level Lumbar Degenerative Disease: A Retrospective Study [J].
Xu, Hongyao ;
Yu, Lei ;
Xiao, Bing ;
Zhao, Hong ;
Gu, Xin ;
Gao, Zengxin ;
Wang, Weiheng .
WORLD NEUROSURGERY, 2024, 183 :E98-E108
[38]   A comparative study of perioperative complications between transforaminal versus posterior lumbar interbody fusion in degenerative lumbar spondylolisthesis [J].
Liu, Jiaming ;
Deng, Huilin ;
Long, Xinhua ;
Chen, Xuanyin ;
Xu, Risheng ;
Liu, Zhili .
EUROPEAN SPINE JOURNAL, 2016, 25 (05) :1575-1580
[39]   Clinical Outcomes of Posterior Lumbar Interbody Fusion versus Minimally Invasive Transforaminal Lumbar Interbody Fusion in Three-Level Degenerative Lumbar Spinal Stenosis [J].
Fan, Guoxin ;
Wu, Xinbo ;
Yu, Shunzhi ;
Sun, Qi ;
Guan, Xiaofei ;
Zhang, Hailong ;
Gu, Xin ;
He, Shisheng .
BIOMED RESEARCH INTERNATIONAL, 2016, 2016
[40]   Radiologic and Clinical Evaluation of Posterolateral Versus Transforaminal Interbody Fusion in Degenerative Lumbar Spondylolisthesis [J].
McDonald, James ;
Al-Jahdali, Fares ;
Urquhart, Jennifer ;
Alahmari, Abdulmajeed ;
Rampersaud, Raja ;
Fisher, Charles ;
Bailey, Chris ;
Glennie, Andrew .
CLINICAL SPINE SURGERY, 2024, 37 (06) :E245-E252