Comparison Between PE-TLIF and MIS-TLIF in the Treatment of Middle-Aged and Elderly Patients with Single-Level Lumbar Disc Herniation

Qi Han; Feifan Meng; Ming Chen; Xiangjun Lu; Deyuan Zhao; Dongze Wu; Tingting Wang; Rujie Qin

doi:10.2147/JPR.S371635

Comparison Between PE-TLIF and MIS-TLIF in the Treatment of Middle-Aged and Elderly Patients with Single-Level Lumbar Disc Herniation

J Pain Res. 2022 Apr 29:15:1271-1282. doi: 10.2147/JPR.S371635. eCollection 2022.

Authors

Qi Han¹, Feifan Meng¹, Ming Chen¹, Xiangjun Lu¹, Deyuan Zhao¹, Dongze Wu¹, Tingting Wang², Rujie Qin¹

Affiliations

¹ Department of Orthopedics, The First People's Hospital of Lianyungang Affiliated to Xuzhou Medical University, Lianyungang, Jiangsu, People's Republic of China.
² Department of Dermatology, The First People's Hospital of Lianyungang Affiliated to Xuzhou Medical University, Lianyungang, Jiangsu, People's Republic of China.

Abstract

Objective: To evaluate the early clinical effect of percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) surgery in the treatment of middle-aged and elderly patients with single-level lumbar disc herniation accompanied by lumbar instability.

Methods: From January 2019 to June 2020, a total of 82 consecutive patients were categorised into PE-TLIF group and MIS-TLIF group based on different surgical methods. The visual analog scale (VAS), Oswestry disability index (ODI), Japanese Orthopaedic Association (JOA) score, perioperative objective serological index, operation time, intraoperative blood loss, time to back to work or normal life, and Modified MacNab score were used as the evaluation indexes. The differences between the two groups were analyzed and the clinical effects were compared.

Results: The VAS back pain of PE-TLIF group was decreased compared to that of MIS-TLIF group in the postoperative 1 week and 1 month. The operative time in PE-TLIF group was obviously longer than that in MIS-TLIF group. The hospital stay was significantly shorter in PE-TLIF group than that in MIS-TLIF group. More intraoperative blood loss and postoperative drainage were recorded in MIS-TLIF group. Compared with MIS-TLIF, PE-TLIF surgery was associated with a shorter time to ambulation after surgery and a shorter time to back to work or normal life. Significant statistical differences were observed in IL-6, CRP, and CK on postoperative 3 days between the two groups.

Conclusion: For middle-aged and elderly patients, PE-TLIF and MIS-TLIF surgery both have obvious clinical efficacy and safety. However, with less intraoperative blood loss, shorter recovery time and less injury to the patients, people undergoing PE-TLIF surgery can return to work or normal life faster. It is speculated that PE-TLIF has a higher incidence of complications and recurrence rate than that MIS-TLIF. PE-TLIF may be a better choice for middle-aged and elderly patients with single-level lumbar disc herniation.

Keywords: lumbar disc herniation; middle-aged and elderly; minimally invasive surgery; minimally invasive transforaminal lumbar interbody fusion; percutaneous endoscopic transforaminal lumbar interbody fusion.

Grants and funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.