Comparison of short-term efficacy of MIS-TLIF and Endo-LIF in the treatment of single-segment degenerative lumbar diseases

Zhiwei Song; Weihua Zhu; Junwen Zheng; Gang Wu; Tianqi Li; Aibing Huang; Jian Bian; Chunmao Chen; Haijun Li

doi:10.3389/fsurg.2022.922930

Comparison of short-term efficacy of MIS-TLIF and Endo-LIF in the treatment of single-segment degenerative lumbar diseases

Front Surg. 2022 Sep 23:9:922930. doi: 10.3389/fsurg.2022.922930. eCollection 2022.

Authors

Zhiwei Song^{1

2}, Weihua Zhu^{1

3}, Junwen Zheng⁴, Gang Wu⁴, Tianqi Li⁴, Aibing Huang^{1

4}, Jian Bian^{1

3}, Chunmao Chen^{1

3}, Haijun Li^{1

3}

Affiliations

¹ Department of Orthopedics, Hospital Affiliated 5 to Nantong University, Taizhou People's Hospital, Taizhou, China.
² Medical School of Nantong University, Nantong, China.
³ Department of Orthopedics, Taizhou People's Hospital, Nanjing Medical University, Taizhou, China.
⁴ Postgraduate Training Base of Dalian Medical University, Taizhou People's Hospital, Jiangsu, China.

Abstract

Background: A prospective controlled study was conducted to compare the short-term clinical results and postoperative complications of minimally invasive transforaminal lumbar decompression and fusion (minimally invasive surgery transforaminal lumbar interbody fusion, MIS-TLIF) and percutaneous endoscope-assisted transforaminal lumbar interbody fusion (endoscopic lumbar interbody fusion, Endo-LIF) in the treatment of single-segment degenerative lumbar diseases, to provide some scientific guidance for clinicians to select surgical treatment for patients with lumbar degeneration.

Methods: From October 2020 to October 2021, a total of 62 patients were enrolled, with 31 patients in the MIS-TLIF group and 31 patients in the Endo-LIF group. All patients were followed up for 6 months. The following information from the two groups of patients was recorded: (1) operation time, radiation exposure time, intraoperative blood loss, bed rest time, and hospital stay; (2) ODI score (The Oswestry Disability Index), low back pain VAS score (Visual Analogue Scale), and lumbar vertebra JOA score (Japanese Orthopaedic Association Scores) 1 day before the operation; 1, 3, 6 days after operation; and 1, 3 and 6 months after operation. (3) X-ray evaluations of lumbar fusion at the last follow-up.

Results: There were significant differences in operation time, intraoperative fluoroscopy time, and hospitalization cost between the two groups. The MIS-TLIF group was significantly better than the Endo-LIF group, and the intraoperative bleeding volume of the Endo-LIF group was significantly better than that of the MIS-TLIF group, but there was no significant difference in postoperative bed rest time and postoperative hospital stay. There was no significant difference in the scores of ODI, VAS, and JOA between the two groups before and after the operation. At the last follow-up, the fusion rate was 100% in the MIS-TLIF group and 100% in the Endo-LIF group.

Conclusions: There was no significant difference in short-term clinical efficacy and safety between Endo-LIF and MIS-TLIF in the treatment of single-segment degenerative lumbar diseases, but MIS-TLIF was significantly better than Endo-LIF in terms of the operation time, hospitalization cost, and fluoroscopy time, and Endo-LIF was significantly better than MIS-TLIF in terms of intraoperative blood loss.

Keywords: lumbar degenerative disease; lumbar vertebrae; minimally invasive; minimally invasive surgery; pedicle screw.