JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2015, Vol. 53 ›› Issue (12): 71-75.doi: 10.6040/j.issn.1671-7554.0.2014.985

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The clinical efficacy of mini-invasive transforaminal lumbar interbody fusion for the treatment of lumbar spondylolisthesis

ZHOU Chao, TIAN Yonghao, ZHENG Yanping, LIU Xinyu, WANG Huhu   

  1. Department of Orthopedics, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Received:2014-12-22 Online:2015-12-10 Published:2015-12-10

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Abstract: Objective To compare the clinical efficacy of mini-invasive transforaminal lumbar inter-body fusion (MIS-TLIF) through Wiltse approach and traditional approach for the treatment of lumbar spondylolisthesis. Methods A total of 70 patients with lumbar spondylolisthesis were randomly divided group A (n=32) receiving MIS-TLIF through Wiltse approach and group B (n=38) receiving MIS-TLIF through traditional approach. In group A, the affected level was L4/5 in 20 cases and L5/S1 in 12 cases; 9 cases had only low back pain (LBP), while 21 cases had both LBP and leg pain; 17 cases had grade I and 14 cases had grade Ⅱ spondylolisthesis. In group B, the affected level was L4/5 in 22 cases and L5/S1 in 16 cases; 11 cases had only LBP, while 27 cases had both LBP and leg pain; 21 cases had grade I and 17 cases had grade Ⅱ spondylolisthesis. The JOA score, VAS of LBP and leg pain were evaluated 3 months, 6 months and 1 year after surgery. The post-operative dynamic X-rays, CT and/or MR were used for imaging evaluation. Results There was no difference in gender, age, affected levels, degree of spondylolisthesis, pre-operative JOA score, VAS of LBP, and VAS of leg pain between groups A and B (P>0.05). The incision length, blood loss and exposure time of group A were better than those of group B (P<0.05). The post-operative JOA scoresand VAS of LBP and leg pain were significantly improved after surgery in both groups A and B. The VAS of LBP in group A was lower than that of group B on day 1, day 14, and 1 year after surgery (P<0.05). The interbody fusion rate was not significantly different between groups A and B (P>0.05). There were no complications of internal fixation in both groups. Conclusion MIS-TLIF through both Wiltse and traditional approaches can acquire satisfactory clinical efficacy. Mini-invasive TLIF through Wiltse approach can significantly reduce the damage of multifidus and postoperative incidence of chronic LBP.

Key words: Spinal fusion, Wiltse approach, Spondylolisthesis, Muscular atrophy, Transforaminal lumbar interbody fusion

CLC Number: 

  • R681.5
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