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Minimally Invasive Transforaminal Lumbar Interbody Fusion in Multilevel: Comparison with Conventional Transforaminal Interbody Fusion.

Authors
 Won-chul Lee  ;  Jeong-Yoon Park  ;  Kyung Hyun Kim  ;  Sung Uk Kuh  ;  Dong Kyu Chin  ;  Keun Su Kim  ;  Yong Eun Cho 
Citation
 World Neurosurgery, Vol.85 : 236-243, 2016 
Journal Title
 World Neurosurgery 
ISSN
 1878-8750 
Issue Date
2016
MeSH
Adult ; Aged ; Cross-Sectional Studies ; Disability Evaluation ; Female ; Follow-Up Studies ; Humans ; Lordosis/diagnostic imaging ; Lumbar Vertebrae/diagnostic imaging ; Lumbar Vertebrae/surgery* ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/methods* ; Postoperative Complications/diagnostic imaging ; Radiography ; Spinal Fusion/methods*
Keywords
Minimally invasive ; Spinal sagittal alignment ; Transforaminal lumbar interbody fusion
Abstract
OBJECTIVE: Minimally invasive (MIS) transforaminal lumbar interbody fusion (TLIF) has shown superior or noninferior results compared with conventional TLIF in single segments. There were no comparative studies between MIS and conventional TLIF in multisegments. The purpose of this study was to compare MIS and conventional TLIF in multisegments. METHODS: This is a cross-sectional study of 2- or 3-segment lumbar degenerative disease that was treated with either MIS (27 cases) or conventional TLIF (43 cases). Whole spine sagittal radiography was done preoperatively and 1 year after surgery. Clinical outcomes, perioperative outcomes, and fusion rate were compared. Radiologic parameters, such as cervical lordosis, thoracic kyphosis, lumbar lordosis, sagittal vertical axis, and pelvic parameters, were measured 1 year after surger. RESULTS: The two groups were similar in age, sex, preoperative diagnosis, operated level, and follow-up period. Both groups showed improvement in visual analog scale and Oswestry disability index after surgery. The MIS TILF group had a significantly shorter operation time (167.10 vs. 216.58 minutes) and less blood loss (532.41 vs. 865.81 mL). Only cervical lordosis (MIS TLIF, -17.2°; conventional TLIF, -11.2°) was significantly different preoperatively between the groups. Postoperatively, there were no significant differences in radiologic parameter and fusion rate. In the intragroup comparisons, thoracic kyphosis, lumbar lordosis, and sacral slope were significantly increased and pelvic tilt was significantly decreased after surgery. CONCLUSIONS: MIS TLIF and conventional TLIF showed similar clinical and radiologic outcomes. MIS TLIF may be a better choice for 2- or 3-segment lumbar fusion in perioperative outcomes.
Full Text
http://www.sciencedirect.com/science/article/pii/S1878875015011729
DOI
10.1016/j.wneu.2015.09.009
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
구성욱(Kuh, Sung Uk) ORCID logo https://orcid.org/0000-0003-2566-3209
김경현(Kim, Kyung Hyun)
김근수(Kim, Keun Su) ORCID logo https://orcid.org/0000-0002-3384-5638
박정윤(Park, Jeong Yoon) ORCID logo https://orcid.org/0000-0002-3728-7784
이원철(Lee, Won Chul)
조용은(Cho, Yong Eun) ORCID logo https://orcid.org/0000-0001-9815-2720
진동규(Chin, Dong Kyu) ORCID logo https://orcid.org/0000-0002-9835-9294
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146813
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