LIU Junlin 1 , KONG Qingquan 1,2 , FENG Pin 1,2 , ZHANG Bin 1,2 , MA Junsong 1 , HU Yuan 1 , WU Xi 1 , SHU Xiang 1 , PU Congmin 1
  • 1. Department of Orthopedics, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region, Chengdu Sichuan, 610041, P. R. China;
  • 2. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China;
KONG Qingquan, Email: kongspine@126.com
Percutaneous coaxial large channel; endoscopic lumbar fusion; degenerative lumbar spinal stenosis; transforaminal approach
10.7507/1002-1892.202202076
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Objective To compare the effectiveness of percutaneous coaxial large-channel endoscopic lumbar interbody fusion (PE-LIF) and minimal invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of degenerative lumbar spinal stenosis. Methods  The clinical data of 134 patients with single-segment degenerative lumbar spinal stenosis who met the selection criteria between January 2019 and January 2021 were retrospectively analyzed, including 52 cases in PE-LIF group and 82 cases in MIS-TLIF group. There was no significant difference in general data such as gender, age, disease duration, surgical segment, and preoperative visual analogue scale (VAS) scores of low back pain and lower extremity pain, and Oswestry disability index (ODI) between the two groups (P>0.05). The operation time, intraoperative blood loss, postoperative drainage, hospitalization stay, and complications were recorded and compared between the two groups. The level of serum creatine kinase (CK) was recorded at 1 day before operation and at 1 and 3 days after operation to evaluate intraoperative muscle damage. The Brantigan criteria was used to evaluate the interbody fusion in the two groups. The VAS scores of low back pain and lower extremity pain at 1 day before operation and at 3 days, 3 months, and 1 year after operation, and the ODI scores at 1 day before operation and at 3 months and 1 year after operation were recorded and compared between the two groups. Results There was no significant difference in operation time and hospitalization stay between the two groups (P>0.05). The intraoperative blood loss and postoperative drainage in the PE-LIF group were significantly lower than those in the MIS-TLIF group (P<0.05). There was no significant difference in serum CK between the two groups before operation (P>0.05), and the serum CK in the PE-LIF group at 1 and 3 days after operation were significantly lower than those in the MIS-TLIF group (P<0.05). All patients were followed up regularly for 1 year. The postoperative VAS scores of low back pain and lower extremity pain and ODI score in both groups were significantly lower than those before operation (P<0.05); there was no significant difference between the two groups (P>0.05). At 1 year after operation, 48 patients in PE-LIF group had successful interbody fusion, and 77 patients in MIS-TLIF group had successful interbody fusion. There was no significant difference in the interbody fusion distribution between the two groups at 3 months and 1 year after operation (P>0.05). There were 2 and 3 cases of lower limb numbness, 1 and 3 cases of neuroedema pain, 1 and 1 case of Cage displacement, 1 and 1 case of pedicle screw loosening in the PE-LIF group and MIS-TLIF group, respectively. No infection or dural sac tearing occurred in the two groups. There was no significant difference in the incidence of complications between the two groups (9.6% vs. 9.8%) (χ2=0.001, P=0.979). Conclusion In the treatment of single-segment degenerative lumbar spinal stenosis, PE-LIF can achieve similar effectiveness as MIS-TLIF, and PE-LIF has less intraoperative blood loss and less muscle damage.

Citation： LIU Junlin, KONG Qingquan, FENG Pin, ZHANG Bin, MA Junsong, HU Yuan, WU Xi, SHU Xiang, PU Congmin. Comparison of effectiveness between percutaneous coaxial large-channel endoscopic lumbar interbody fusion and minimal invasive transforaminal lumbar interbody fusion in treatment of degenerative lumbar spinal stenosis. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(6): 681-690. doi: 10.7507/1002-1892.202202076 Copy

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