الفهرس | Only 14 pages are availabe for public view |
Abstract SUMMARY & CONCLUSION pen Transforaminal Lumbar Interbody Fusion (TLIF) is widely performed to treat different spine pathologies safely since three decades after being introduced by Harms. However, it is associated with significant postoperative morbidity due to extensive muscle retraction and dissection needed for surgical exposure. Mini-invasive TLIF is a promising technique due to lower complication rates and approach-related morbidity with minimal soft tissue trauma, decreased intra-operative blood loss and risk of transfusion, decreased postoperative pain and analgesic usage, shorter hospital stays, earlier ambulation with faster return to work and thus reduced overall health care costs. The aim of the current study was to evaluate functional outcome of mini-invasive TLIF technique in comparison to conventional open TLIF as regard the intra-operatively and postoperative period till achieving solid fusion. Sixty one patients were enrolled in the current study, were divided into 2 groups; 31 patients were managed by mini-open TLIF technique (group A), while the other 30 patients were managed by conventional open TLIF technique (group B). The follow-up period was 24 months for all patients. Inclusion criteria were patients having spinal canal stenosis with unilateral lower limb manifestations and patients with O Summary & Conclusion 128 degenerative causes of lumbar spine stenosis. Exclusion criteria were patients who refuse to be part of our study, patients with spinal canal stenosis with bilateral lower limbs manifestations, non degenerative causes of lumbar stenosis and patients require decompression for more than 2 levels. 35 females and 26 males were included in the study. Mean age of “group 1” patients was 54.13 years while in “group 2” was 56.50 years. In group 1, 25 cases had single level pathology (80.65%), and 6 cases had 2 diseased levels (19.35%), while in group 2, 25 cases (83.33%) had diseased single level, and double level involved in 5 cases (16.67%). There was significant postoperative pain relief, marked improvement in the functional outcome at 1 month, 6 and 24 months in all cases in both groups, but the difference was statistically insignificant. Operative time and radiation exposure were significantly higher in the mini-invasive group compared to the open group. The complications encountered were very few; including one case of superficial infection and another case of dural tear. No major or neurovascular complications were encountered in the current study. Summary & Conclusion 129 In conclusion, The Mini-invasive TLIF technique provides similar efficacy to the conventional open technique in long-term clinical outcome and fusion rate, with the additional benefits of less initial postoperative pain, early rehabilitation, shorter hospitalization, and fewer complications. |