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J Neurol Surg A Cent Eur Neurosurg 2024; 85(01): 039-047
DOI: 10.1055/a-1994-7857
Original Article

Is Full-Endoscopic Transforaminal Lumbar Interbody Fusion Superior to Open Transforaminal Lumbar Interbody Fusion for Single-Level Degenerative Lumbar Spondylolisthesis? A Retrospective Study

Autoren

  • Jianjian Yin   *

    1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, People's Republic of China

  • Xijia Jiang   *

    1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, People's Republic of China

  • Nanwei Xu

    1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, People's Republic of China

  • Luming Nong 

    1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, People's Republic of China

  • Yuqing Jiang

    1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, People's Republic of China

Funding The research was supported by the general project of Jiangsu Provincial Department of Health (H2019025); Six Talent Peaks Project, Jiangsu Provincial Finance Department (WSW-186); and Jiangsu Provincial Social Development Project (BE2020650).
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Abstract

Background In this study, we evaluate the clinical efficacy and safety of full-endoscopic transforaminal lumbar interbody fusion (TLIF) for treatment of single-level lumbar degenerative spondylolisthesis.

Methods Fifty-three patients were divided into two groups according to the surgical techniques: Full endoscopic (Endo)-TLIF (n = 25) and TLIF (n = 28). Clinical efficacy was evaluated pre- and postoperatively. The operation time, operative blood loss, postoperative amount of serum creatine phosphokinase (CPK), postoperative drainage volume, postoperative hospital stay time, total cost, and operative complications were also recorded.

Results Compared with the TLIF group, the Endo-TLIF group had similar intraoperative blood loss, less postoperative increased CPK, less postoperative drainage volume, and shorter postoperative hospital stay, but longer operative time and higher total cost. The postoperative visual analog scale (VAS) scores of back and leg pain and Oswestry Disability Index (ODI) scores significantly improved compared with the preoperative scores in both two groups; more significant improvement of postoperative VAS scores of back pain and ODI scores were shown in the Endo-TLIF group at the 1-month follow-up (p < 0.05). No difference was found in the intervertebral fusion rate between the two groups.

Conclusion The Endo-TLIF has similar clinical effect compared with the TLIF for the treatment of lumbar degenerative spondylolisthesis. It also has many surgical advantages such as less muscle trauma, less postoperative back pain, and fast functional recovery of the patient. However, steep learning curve, longer operative time, and higher total cost may be the disadvantages that limit this technique. Also, the Endo-TLIF treatment of patients with bilateral lateral recess stenosis is considered a relative contraindication.

Keywords

degenerative spondylolisthesis - full-endoscopic transforaminal lumbar interbody fusion - TLIF - percutaneous pedicle screw

Author Contributions

L.M.N. and Y.Q.J. were responsible for conception and design of the study, and final approval of the version to be published. Acquisition of data, analysis, and interpretation of data were performed by J.J.Y. and X.J.J. Drafting and revision of the article were done by N.W.X. All the authors read and approved the final manuscript.


Availability of Data and Materials

The datasets supporting the conclusions of this article are included within the article. The raw data can be requested from the corresponding author upon reasonable request.


Ethics Approval and Consent to Participate

This study was approved by the Affiliated Changzhou No. 2 People's Hospital with Nanjing Medical University Institutional Review Board (IRB), and due to the retrospective nature of the study, informed consent is waived by the institute review board under ethics approval and consent to participate section. All procedures performed in this study were in accordance with the ethical standards of the national research committee.


* Co-first authors: Jianjian Yin and Xijia Jiang.




Publikationsverlauf

Eingereicht: 21. Januar 2022

Angenommen: 05. Dezember 2022

Accepted Manuscript online:
08. Dezember 2022

Artikel online veröffentlicht:
31. Juli 2023

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