Comparisons of Lumbar Muscle Performance Between Minimally-Invasive and Open Lumbar Fusion Surgery at 1-Year Follow-Up

Lu, Meng‐Ling; Cheng, Chih-Hsien; Chen, Wen-Chien; Fu, Chen-Ju; Niu, Chi‐Chien

doi:10.1177/2192568220979666

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…Overall, the results of the current study are consistent with ndings reported by Liu et al 10 . Growing literature suggests that the fusion rate of the intervertebral cage may affect the clinical outcomes of patients [28][29][30][31] . The present study found no signi cant difference in the fusion rate between the two surgical methods at the one-year postoperative follow-up, suggesting that both techniques can achieve the expected fusion results(Fig.…”

Section: Discussionmentioning

confidence: 99%

Comparison Of A Novel Hand-held Retractor-Assisted Transforaminal Lumbar Interbody Fusion By The Wiltse Approach And Posterior TLIF

Shen,

Li,

Chen

et al. 2023

Preprint

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Background: Previously, achieving spinal canal decompression through the traditional Wiltse approach has been challenging due to limitations of assisted hand-held retractors. However, recent improvements to the retractors by some surgeons have facilitated spinal canal decompression in the Wiltse approach and have resulted in successful surgical outcomes. Nevertheless, there is a paucity of literature to assess the safety and efficacy of hand-held retractor assisted Wiltse approach TLIF. This study aims to compare the clinical outcomes and safety of a novel hand-held retractor system-assisted Wiltse TLIF with that P-TLIF and assess whether this hand-held retractor system assisted Wiltse TLIF can yield less paraspinal muscle injury. Methods: 56 patients(P-TLIF: 26, Wiltse TLIF: 30) were included in this prospective controlled study. The operation time, intraoperative blood loss, postoperative drainage, mobilization time, and discharge time were recorded. The clinical outcomes were evaluated by ODI, VAS, JOA, and SF-36 scores.Paraspinal muscle injury was assessed by postoperative MRI. CK and C-reaction protein were measured pre and postoperatively, and CT or X-ray was used to assess bony union/non-union. Results: The Wiltse (study) group was associated with significantly less estimated blood loss, postoperative drainage, and shorter mobilization and discharge times than the P-TLIF (control) group. Serum CK activity at 24h postoperatively in the study group was significantly lower than in the control group.. The incidence of complications in the two groups was comparable. At 7 days after surgery, VAS and ODI scores were lower, while the JOA score was higher in the control group than in the study group. Results observed at 3 months of follow-up were consistent with those at 7 days. After six months postoperatively, paraspinal muscle degeneration in the control group was more significant than in the study group Conclusion:Our study showed that this novel hand-held retractor system assisted Wiltse approach TLIF can achieve satisfactory surgical efficacy, and the Wiltse approach TLIF can significantly reduce paraspinal muscle injury, postoperative drainage, and intraoperative blood loss, as well as shorten mobilization and discharge time, resulting in better short-term outcomes compared to P-TLIF. Furthermore, both methods yield similar fusion rates and incidence of complications . Trial registration:, 25/09/2023 NCT06052579

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Section: Discussionmentioning

confidence: 99%

Comparison Of A Novel Hand-held Retractor-Assisted Transforaminal Lumbar Interbody Fusion By The Wiltse Approach And Posterior TLIF

Shen,

Li,

Chen

et al. 2023

Preprint

View full text Add to dashboard Cite

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The impact of physical and psychological pain management training on pain intensity, anxiety and disability in patients undergoing lumbar surgeries

et al. 2023

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Comparison of a novel hand-held retractor-assisted transforaminal lumbar interbody fusion by the wiltse approach and posterior TLIF: a one-year prospective controlled study

Shen,

Li,

Quan Cheng

et al. 2024

BMC Musculoskelet Disord

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Background This study aims to compare the clinical outcomes and safety of a novel hand-held retractor system-assisted Wiltse TLIF with that P-TLIF and assess whether this hand-held retractor system assisted Wiltse TLIF can yield less paraspinal muscle injury. Methods 56 patients (P-TLIF: 26, Wiltse TLIF: 30) were included in this one year prospective controlled study. The operation time, intraoperative blood loss, postoperative drainage, mobilization time, and discharge time were recorded. The clinical outcomes were evaluated by ODI, VAS, JOA, and SF-36 scores (7 days, 3, 6, and 12 months after surgery). Paraspinal muscle injury was assessed by postoperative MRI (6 months after surgery). CK and C-reaction protein were measured pre and postoperatively, and CT or X-ray (one year postoperatively) was used to assess bony union/non-union. Results The Wiltse (study) group was associated with significantly less estimated blood loss (79.67 ± 28.59 ml vs 192.31 ± 59.48 ml, P = 0.000*), postoperative drainage (43.33 ± 27.89 ml vs 285.57 ± 123.05 ml, P = 0.000*), and shorter mobilization (4.1 ± 1.2 d vs. 3.0 ± 0.9 d, P < 0.05) and discharge times (7.7 ± 1.9 d vs. 6.1 ± 1.2 d, P = 0.002*) than the P-TLIF (control) group. Serum CK activity at 24 h postoperatively in the study group was significantly lower than in the control group (384.10 ± 141.99 U/L vs 532.76 ± 225.76 U/L, P = 0.018*). At 7 days after surgery, VAS (2.3 ± 0.6 vs 3.2 ± 0.7, P = 0.000*)and ODI scores (43.9 ± 11.9 vs 55.2 ± 12.9, P = 0.001*) were lower, while the JOA scores (18.4 ± 3.4 vs 16.3 ± 4.2, P = 0.041*) was higher in the control group than in the study group. Results observed at 3 months of follow-up were consistent with those at 7 days. After six months postoperatively, paraspinal muscle degeneration in the control group was more significant than in the study group (P = 0.008*). Conclusion Our study showed that this novel hand-held retractor system assisted Wiltse approach TLIF can significantly reduce paraspinal muscle injury, postoperative drainage, and intraoperative blood loss, mobilization and discharge time, as well as yield better short-term outcomes compared to P-TLIF. Trial registration 25/09/2023 NCT06052579.

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Comparisons of Lumbar Muscle Performance Between Minimally-Invasive and Open Lumbar Fusion Surgery at 1-Year Follow-Up

Cited by 3 publications

References 24 publications

Comparison Of A Novel Hand-held Retractor-Assisted Transforaminal Lumbar Interbody Fusion By The Wiltse Approach And Posterior TLIF

Comparison Of A Novel Hand-held Retractor-Assisted Transforaminal Lumbar Interbody Fusion By The Wiltse Approach And Posterior TLIF

The impact of physical and psychological pain management training on pain intensity, anxiety and disability in patients undergoing lumbar surgeries

Comparison of a novel hand-held retractor-assisted transforaminal lumbar interbody fusion by the wiltse approach and posterior TLIF: a one-year prospective controlled study

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