Comparison Of Mis-tlif And Wiltse-open-TLIF For Single-Level Lumbar Disc Herniation

Objective:To compare the clinical effects of minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)and open Wiltse paras pinal sacrospinalis splitting approach TLIF(Wiltse-Open-TLIF)on single-level lumbar disc herniation.Methods:In the department of Spinal surgery in Jiangxi provincial People’s hospitail,from January 2014 to March 2017,one hundred and sixty-one patients with single-level lumbar disc herniation were treated with Wiltse-Open-TLIF(79 cases)or MIS-TLIF(82 cases),and were followed up for more than 12 months.Operation time,incision size,intraoperative fluoroscopy times,intraoperativeblood loss,postoperative incision drainage,postoperative bedridden time,hospitalization time,complications,VAS score,ODI score,fusion rate at last follow-up and surgical revision rate were compared between the two groups.Results:There were no significant differences between two groups in operation time,complications,fusion rate at last follow-up,surgical revision rate,postoperative lower limb VAS score,and ODI score(P> 0.05).Compared with Wiltse-Open-TLIF group,incision size,intraoperative blood loss,postoperative incision drainage,postoperative bedridden time and hospitallization time decreased,but intraoperative fluoroscopy time increased in MIS-TLIF group(P< 0.05).In addition,the low back pain VAS score in MIS-TLIF group was lower than that in Wiltse-Open-TLIF group 1 month after operation(P< 0.05),but difference was on significant between the two groups 3 month after operation(P> 0.05).Conclusions:Both the MIS-TLIF and Wiltse-Open-TLIF have good effect on single-level lumbar disc herniation.However,MIS-TLIF is associated with small incision minor soft tissue injury,less intraoperative bleeding and rapid recovery.