Comparison Between PE-TLIF and MIS-TLIF in the Treatment of Middle-Aged and Elderly Patients with Single-Level Lumbar Disc Herniation

Han, Qi; Meng, Feifan; Chen, Ming; Lu, Xiangjun; Zhao, Deyuan; Wu, Dongze; Wang, Tingting; Qin, Rujie

doi:10.2147/jpr.s371635

Cited by 10 publications

(20 citation statements)

References 37 publications

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“…In our study, Endo-LIF was associated with longer operative time, significant improvement in other hospital-related outcomes and post-operative back pain, with overall similar post-operative leg pain, disability, fusion rates, and complications -suggesting that Endo-LIF may be effective, safe, and comparable in most domains to MIS and open techniques, for the management of LDD. However, for some analyses, we observed substantial heterogeneity, which may Endo-LIF vs MIS-LIF: forest plots with the mean difference for post-operative leg pain (6,15,16,18,21,22,23,29,35,36). https://doi.org/10.1530/EOR-23-0167 Spine be explained by differences across studies, including the year of publication, endoscopic technique, and/or approach (uniportal versus biportal and interlaminar versus transforaminal).…”

Section: Discussionmentioning

confidence: 95%

“…with open techniques compared to Endo-LIF (31,32,33,36). Future studies may assess whether these findings may influence treatment decision-making, particularly for high morbidity and frail patients (44).…”

Section: Surgical-and Hospital-related Outcomesmentioning

confidence: 99%

“…Bedtime and hospital length of stay were significantly longer in the Open-LIF and MIS-LIF groups. Extensive surgical-induced trauma may have an impact on these outcomes -previous works suggested local and systemic effects induced by these surgical techniques, with reported higher levels of systemic inflammatory markers (creatine kinase protein, C-reactive protein, erythrocyte sedimentation rate, interleukin-6, and tumor necrosis factor-α) and elevated injury and fatty infiltration rates in multifidus muscles Endo-LIF vs MIS-LIF: forest plots with the mean difference for post-operative disability (6,14,15,16,18,21,22,23,29,35,36,38).…”

Section: Surgical-and Hospital-related Outcomesmentioning

confidence: 99%

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Is endoscopic technique an effective and safe alternative for lumbar interbody fusion? A systematic review and meta-analysis

Relvas-Silva,

Pinto,

Sousa

et al. 2024

EFORT Open Reviews

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Study design Systematic review; meta-analysis. Purpose Lumbar degenerative disease is frequent and has a tremendous impact on patients’ disability and quality-of-life. Open and minimally invasive procedures have been used to achieve adequate decompression and fusion. Endoscopic lumbar interbody fusion (Endo-LIF) is emerging as an alternative, trying to reduce morbidity, while achieving comparable to superior clinical outcomes. The aim of this work is to perform a systematic review and meta-analysis to investigate how Endo-LIF compares to open or minimally invasive procedures. Methods Electronic databases (MEDLINE, Scopus, Web of Science, Cochrane) were systematically reviewed using the query: ‘(percutaneous OR endoscop*) AND (open OR minimal* invasive) AND lumbar AND fusion’. PRISMA guidelines were followed. Results Twenty-seven articles were included (25 cohort study, 1 quasi-experimental study, and 1 randomized control trial; for meta-analytical results, only observational studies were considered). Endo-LIF conditioned longer operative time, with significantly lower blood loss, bedtime, and hospital length of stay. Early post-operative back pain favored endoscopic techniques. Endo-LIF and non-Endo-LIF minimally invasive surgery displayed comparable results for most back and leg pain or disability outcomes, despite Endo-LIF having been associated with higher disability at late follow-up (versus Open-LIF). No differences were found regarding fusion rates, cage subsidence, or adverse events. Definitive conclusions regarding fusion rate cannot be drawn due to low number of studies and unstandardized fusion definition. Conclusion Endo-LIF is an effective and safe alternative to conventional lumbar interbody fusion procedures. Evidence shortcomings may be addressed, and future randomized control trials may be performed to compare techniques and to validate results.

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Section: Discussionmentioning

confidence: 95%

Section: Surgical-and Hospital-related Outcomesmentioning

confidence: 99%

Section: Surgical-and Hospital-related Outcomesmentioning

confidence: 99%

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Is endoscopic technique an effective and safe alternative for lumbar interbody fusion? A systematic review and meta-analysis

Relvas-Silva,

Pinto,

Sousa

et al. 2024

EFORT Open Reviews

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“…Lumbar disc herniation (LDH) is a common chronic orthopaedic disease closely related to aging and is the most common reason for sciatica and lower back pain (LBP) in the elderly population. 1 , 2 LDH is very common among elderly people from at age of 60 years old. 3 Sciatica and LBP are the main symptoms of LDH, with a lifetime prevalence of 84%.…”

Section: Introductionmentioning

confidence: 99%

Paravertebral Muscular Neurophysiological Function as an Independent Outcome Predictor of Recurring Herniation/Low Back Pain after Radiofrequency Ablation: A Prospective Follow‐Up and Case‐Control Study Based on Surface Electromyography

Li,

Xing,

et al. 2024

Orthopaedic Surgery

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ObjectiveSpinal endoscopy radiofrequency is a minimally invasive technique for lumbar disc herniation (LDH) and low back pain (LBP). However, recurring LDH/LBP following spinal endoscopy radiofrequency is a significant problem. Paravertebral musculature plays a crucial role in spine stability and motor function, and the purpose of the present study was to identify whether patients’ baseline lumbar muscular electrophysiological function could be a predictor of recurring LDH/LBP.MethodsThis was a prospective follow‐up and case‐control study focusing on elderly patients with LDH who were treated in our department between January 1, 2018, and October 31, 2021. The end of follow‐up was recurring LBP, recurring LDH, death, missing to follow‐up or 2 years postoperation. The surface electromyography test was performed before the endoscopy C‐arm radiofrequency (ECRF) operation to detect the flexion–relaxation ratio (FRR) of the lumbar multifidus (FRRLM) and the longissimus erector spinae (FRRES), and the other baseline parameters included the general characteristics, the visual analogue scale, the Japanese Orthopaedic Association score, and the Oswestry Disability Index. Intergroup comparisons were performed by independent t‐test and χ2‐test, and further binary logistic regression analysis was performed.ResultsFifty‐four patients completed the 2‐year follow‐up and were retrospectively divided into a recurring LDH/LBP group (Group R) (n = 21) and a no recurring group (Group N) (n = 33) according to their clinical outcomes. FRRLM and FRRES in Group N were much higher than those in Group R (p < 0.001, p = 0.009). Logistic regression analysis showed that only the FRRLM (odds ratio [OR] = 0.123, p = 0.011) and FRRES (OR = 0.115, p = 0.036) were independent factors associated with the ECRF outcome.ConclusionsLumbar disc herniation patients’ baseline FRRLM and FRRES are independent outcome predictors of recurring LDH/LBP after ECRF. For every unit increase in baseline FRRLM, the risk of recurring LDH/LBP is decreased by 87.7%, and for every unit increase in baseline FRRES, the risk of recurring LDH/LBP is decreased by 88.5%.

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“…It can be performed under local anesthesia, especially in elderly patients who are frail and have underlying diseases, and thus effectively avoids the risks associated with general anesthesia ( 9 , 10 ). Thus, in recent years, minimally invasive surgery has gradually replaced traditional open surgery as the standard procedure for the treatment of LDH ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Analysis of the therapeutic effect and postoperative complications associated with 3-dimensional computed tomography navigation-assisted intervertebral foraminoscopic surgery in lumbar disc herniation in the elderly: a retrospective cohort study

Yang,

2023

Quant Imaging Med Surg

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Background With the increasing aging of the population, the incidence of lumbar disc herniation (LDH) is gradually increasing. The 3-dimensional (3D) computed tomography (CT) navigation-assisted intervertebral foraminoscopic surgery for LDH is minimally invasive, and due to its localization and guidance features, it can precisely reach the target location. This study sought to investigate the treatment effect and the incidence of postoperative complications of 3D CT navigation-assisted intervertebral foraminoscopic surgery in elderly patients with LDH to provide a reference basis for improving patient prognosis. Methods We retrospectively included 213 elderly patients with LDH admitted to our hospital from October 2017 to October 2021 in this study and followed them up for 1 year. Among them, 103 patients (Group A) underwent conventional C-arm fluoroscopy-assisted system alone intervertebral foraminoscopic surgery, and 110 patients (Group B) underwent 3D CT navigation-assisted intervertebral foraminoscopic surgery. The general characteristics of the participants were compiled using a general information questionnaire designed by the investigator. The t -test and chi-square test were used to analyze the relationship between the treatment outcomes and surgical modalities. Binary logistics regression was used to analyze the independent risk factors affecting patient outcomes. Results The patients who underwent 3D CT navigation-assisted intervertebral foraminoscopic surgery had significantly better outcomes than those who underwent conventional C-arm fluoroscopy-assisted system alone intervertebral foraminoscopic surgery. The binary logistic regression analysis results showed that in addition to the surgical method [odds ratio (OR) =0.258, P=0.042], the history of lumbar trauma (OR =11.001, P=0.005), usual work intensity (OR =4.589, P=0.002), disease duration (OR =3.587, P=0.017), the presence of diabetes (OR =3.315, P=0.026), the presence of a ruptured annulus fibrosus (OR =3.485, P=0.012), the degree of disc degeneration (OR =3.899, P=0.009), and the number of punctures (OR =0.412, P=0.034) were independent risk factors affecting patient outcomes. Conclusions 3D CT navigation-assisted intervertebral foraminoscopic surgery for LDH effectively reduced the number of punctures, decreased intraoperative bleeding and postoperative drainage volumes, shortened the length of hospitalization, bed rest time and operative time, reduced stress reactions, decreased the degree of low-back pain, and the risk of complications, had better overall efficacy, and significantly improved patient prognosis.

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Comparison Between PE-TLIF and MIS-TLIF in the Treatment of Middle-Aged and Elderly Patients with Single-Level Lumbar Disc Herniation

Cited by 10 publications

References 37 publications

Is endoscopic technique an effective and safe alternative for lumbar interbody fusion? A systematic review and meta-analysis

Is endoscopic technique an effective and safe alternative for lumbar interbody fusion? A systematic review and meta-analysis

Paravertebral Muscular Neurophysiological Function as an Independent Outcome Predictor of Recurring Herniation/Low Back Pain after Radiofrequency Ablation: A Prospective Follow‐Up and Case‐Control Study Based on Surface Electromyography

Analysis of the therapeutic effect and postoperative complications associated with 3-dimensional computed tomography navigation-assisted intervertebral foraminoscopic surgery in lumbar disc herniation in the elderly: a retrospective cohort study

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