Contrastive Study Of MIS-TLIF And PLIF In The Treatment Of Patients With Lumbar Spondylolisthesis

Objective To provide the more reasonable and effective surgical plan in the treatment of the patients with lumbar spondylolisthesis,two groups of patients with lumbar spondylolisthesis were treated by PLIF and MIS-TLIF respectively and compare with short-term clinical efficacy and merits in the two kinds of surgical treatment of lumbar spondylolisthesis.Methods A total of 30 patients were diagnosed as spondylolisthesis with concurrent surgical treatment from January 2015 to December 2017 at Dalian Medical University Affiliated Dalian City Central Hospital.Among them,16 patients in PLIF group and 14 patients in MIS-TLIF group were compared the length of the incision,operation time,intraoperative blood loss,postoperative drainage volume,bedridden time,inpatient stay and other data differences.After 12 months of follow-up,the two groups were compared in terms of slippage reduction,VAS score and Oswestry disability index,fusion rates and complication rates.Data analyzed by statistical software SPSS24.0.Rusults 1.There was no significant difference(P> 0.05)between the two groups in terms of age,gender,degree of lumbar spondylolisthesis,classification of lumbar spondylolisthesis,responsible segments of lumbar spondylolisthesis.2.The length of incision,operation time,intraoperative blood loss,postoperative drainage,bedridden time and inpatient stay were collected during and after operation.The results showed that the length of incision(7.03 ± 0.58cm)was significantly smaller than that of the PLIF group(10.74 ± 1.67cm).The intraoperative blood loss(170.00 ± 37.62ml)in the MIS-TLIF group was significantly lower than that of the PLIF group(353.75 ± 70.42ml).The postoperative drainage volume(120.36±17.48ml)in MIS-TLIF group was significantly lower than that in PLIF group(283.75±28.02ml),and the MISTLIF group’s bedridden time(3.07 ± 0.62d)was significantly shorter than that of PLIF patients(4.13 ± 1.26d),the hospitalization time of MIS-TLIF patients(14.93 ± 4.12d)was significantly shorter than that of PLIF patients(17.88 ± 2.33d).The difference of the measured data mentioned above between the two groups is significant(P <0.05).The operation time of the two groups was very similar(198.13 ± 21.98 min in PLIF group and 210.71 ± 18.59 min in MIS-TLIF group),with no significant difference(P> 0.05).3.The VAS score,Oswestry disability index and preoperative spondylolisthesis of the two groups were compared before and after operation,and found no statistical difference between the two groups of patients,with comparable.The VAS score of 6 months and 12 months after operation,Oswestry disability index of 3 months,6 months and 12 months after operation,and degree of lumbar spondylolisthesis were collected.There was no significant difference between the two groups(P> 0.05).However,the VAS score of 7 days,1 month,3months after operation showed that the MIS-TLIF group was able to relieve pain symptoms more obviously than PLIF group in short-term after operation(P<0.05).4.Among the patients in the PLIF group,all patients underwent successful fusion after operation,with no complication such as loosening of internal fixations or cerebrospinal fluid leakage.The interbody fusion failure and loosened pedicle screw was found on the same one patient(7.1%)in the MIS-TLIF group.However,there was no statistical difference in complication rate and fusion rate between the two groups(P> 0.05).Conclusion MIS-TLIF has some merits over PLIF in terms of surgical incision length,intraoperative blood loss,postoperative drainage volume,bedridden time,inpatient stay,and short-term postoperative improvement of pain symptoms.MIS-TLIF is an effective option in the treatment of patients with lumbar spondylolisthesis for the operator.