Comparative effectiveness research of different surgical strategy for multi-segmental lumbar spinal stenosis: transforminal lumbar interbody fusion versus posterior lumbar interbody fusion
Xu Peng, Shi Jiangang, Ye Xiaojian, Shi Guodong, Xu Guohua, Guo Yongfei, Hou Yang, Yuan Wen, Jia Lianshun
Department of Spinal Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai 200003, China
Abstract：Objective To compare the clinical effect of transforminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF) in the treatment of multi-segmental lumbar spinal stenosis. Methods A total of 152 patients who underwent surgery in Changzheng Hospital for multi-segmental lumbar spinal stenosis from January 2013 to June 2014 had a minimum follow up of 1 year and were evenly divided into two groups: TLIF group(80 patients) and PLIF group(72 patients). The operation time and blood loss during operation were compared. Meanwhile, lumbar pain visual analogue scales(VAS) score and Japanese Orthopaedic Association (JOA) score system were used to evaluate the treatment effect at pre-operation, 3rd month post-operation and last follow-up, respectively. Results The blood loss during operation of TLIF group [(658±225)mL] was less than PLIF group [(772±324)mL]. There was significantly statistical difference between two groups(t=-2.534, P<0.05), but the operation time [(3.84±1.00) h vs (3.94±0.99) h]was similar between two groups (t=-0.596, P>0.05).There was no difference in lumbar pain VAS scores between two groups at pre-operation and last follow up (t=1.080, -0.770, all P values>0.05), but the VAS scores of TLIF group were significantly lower than those of PLIF group at 3rd month post-operation (t=-3.351, P<0.05). There was no difference in JOA scores between two groups preoperatively, 3rd month post-operation and last follow up (t=-1.122, 0.522, -1.070, all P values>0.05). The VAS scores and JOA scores of both groups significantly increased at 3rd month post-operation respectively and increased at last follow-up respectively(all P values<0.01). Conclusions Both TLIF and PLIF are effective in the treatment of multi-segmental lumbar spinal stenosis. TLIF is better than PLIF on blood loss during operation and back muscle recovery.
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Xu Peng, Shi Jiangang, Ye Xiaojian, Shi Guodong, Xu Guohua, Guo Yongfei, Hou Yang, Yuan Wen, Jia Lianshun. Comparative effectiveness research of different surgical strategy for multi-segmental lumbar spinal stenosis: transforminal lumbar interbody fusion versus posterior lumbar interbody fusion. Chinese Journal of Anatomy and Clinics, 2016, 21(3): 226-230.
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2016, Vol. 21 
