Clinical Efficacy Comparison Of Modified Minimally Invasive Surgery TLIF And Conventional TLIF For Lumbar Disc Herniation

Objective:To compare the clinical effects of modified minimally invasive surgery TLIF(M-MIS-TLIF)and posterior median approach TLIF(OPEN-TLIF)for lumbar disc herniation.Methods:In this study,240 patients with lumbar disc herniation and received treatment in the Qilu Hospital from August 2017 to March 2019 were selected according the inclusion criteria and divided randomly into two groups:118 patients were treated with OPEN-TLIF surgery while 122 patients were treated with M-MIS-TLIF surgery.All patients were followed up for at least 12 months.Clinical Efficacy comparison of the two groups were underwent by comparing operation time,intraoperative blood loss,length of incision,number of intraoperative fluoroscopy,drainage volume for 24 hours after the operation,postoperative bed time,VAS score,ODI score,NRS score,M-JOA score,multiple crack intramuscular fatty infiltration MRI index score,upper disc fixed fusion segments,Macnab therapeutic effect evaluation and fusion rate assay(Bridwell method and Suk method).Results:In this study,no significant statistical difference was displayed between the two groups in terms of age,gender,lesion segment distribution,preoperative VAS score,preoperative ODI score,preoperative NRS score and preoperative M-JOA score(P>0.05).Moreover,there was also no difference in postoperative long-term VAS score,postoperative long-term ODI score,postoperative long-term NRS score,postoperative long-term M-JOA score,postoperative long-term modified MRI index of fusion segment of upper intervertebral disc,and postoperative long-term Macnab therapeutic effect evaluation between the two groups(P>0.05).However,in terms of surgical incision length,drainage volume for 24 hours after the operation,postoperative bed time,short-term postoperative VAS score,short-term postoperative ODI score,short-term postoperative NRS score,short-term postoperative M-JOA score,and score of multi-fissure intramuscular fat infiltration,M-MIS-TLIF group showed remarkable advantages than OPEN-TLIF group(P<0.05).Additionally,the screw-rod system in all patients were performed well and the positions were satisfactory without displacement.There was no significant difference in fusion rate assayed by Bridwell method and Suk method between the two groups(P>0.05).Conclusion:Both M-MIS-TLIF and OPEN-TLIF were effective in the treatment of lumbar disc herniation.Compared with OPEN-TLIF,M-MIS-TLIF has great advantages in terms of incision length,intraoperative blood loss,postoperative 24-hour drainage volume,postoperative bed time and improvement of early postoperative symptoms.Furthermore,as integrated with the concept of mini mally invasive spine surgery,M-MIS-TLIF not only has the same minimally invasive advantages of MIS-TLIF,but also cast aside the restriction of channels.With lower equipment cost and shorter learning time than MIS-TLIF,M-MIS-TLIF is worth promoting in the clinical use.