Comparison of Minimally Invasive and Open Transforaminal Lumbar Interbody Fusion for Lumbar Disc Herniation: A Retrospective Cohort Study

Zhao, Jinqiu; Zhang, Shujun; Li, Xiaosong; He, Bin; Ou, Yunsheng; Jiang, Dianming

doi:10.12659/msm.912808

Cited by 24 publications

(31 citation statements)

References 40 publications

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“…A multitude of studies have shown a certain superiority of MIS for PLIF and TLIF approaches. 5,14,15,31 Perioperative outcomes like blood loss, 5,14,15 length of stay, 5,14,31 and operative time have shown to be improved in patients undergoing MIS compared to open procedures. 5 Additionally in…”

Section: Discussionmentioning

confidence: 99%

Robot-Guided Transforaminal Versus Robot-Guided Posterior Lumbar Interbody Fusion for Lumbar Degenerative Disease

2021

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Objective There have been no clinical studies comparing different robotic techniques. We compare minimally invasive, robot-guided transforaminal lumbar interbody fusion (RG-TLIF) and mini-open robot-guided posterior lumbar interbody fusion (RG-PLIF). Methods Using data from a prospective institutional registry, we identified 38 patients who underwent RG-PLIF. Propensity score matching using a nearest-neighbor algorithm was implemented to select RG-TLIF controls. Twelve-month patient-reported outcome measures are presented. A reduction of ≥ 30% from baseline was defined as the minimum clinically important difference (MCID). Results Among the 76 included patients, there was no difference between RG-TLIF and RG-PLIF in surgical time (132.3 ± 29.4 minutes vs. 156.5 ± 53.0 minutes, p = 0.162), length of stay (55.9 ± 20.0 hours vs. 57.2 ± 18.8 hours, p = 0.683), and radiation dose area product (310.6 ± 126.1 mGy × cm 2 vs. 287.9 ± 90.3 mGy × cm 2 , p = 0.370). However, while there was no difference among the 2 groups in terms of raw postoperative patient-reported outcome measures scores (all p > 0.05), MCID in leg pain was greater for RG-PLIF (55.3% vs. 78.9%, p = 0.028), and MCID in Oswestry Disability Index was greater for RG-TLIF (92.1% vs. 68.4%, p = 0.009). There was no difference concerning back pain (81.6% vs. 68.4%, p = 0.185). Conclusion Our findings suggest that both RG-TLIF and RG-PLIF are viable and equally effective techniques in robotic spine surgery.

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Section: Discussionmentioning

confidence: 99%

Robot-Guided Transforaminal Versus Robot-Guided Posterior Lumbar Interbody Fusion for Lumbar Degenerative Disease

2021

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“…Many methods have been developed to control bleeding during spinal surgery and mainly include minimal invasion procedures, patient positioning, deliberate hypotension, intraabdominal pressure control, infiltration of paraspinal tissues using vasoconstrictors, and pharmacological agents to enhance coagulation [10,[22][23][24][25]. TXA is known as an antifibrinolytic agent and acts through blocking the interaction of plasminogen and plasmin by competing with the lysine residues on the surface of fibrin to inhibit the fibrinolysis, resulting in clot stabilization [26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

“…Transforaminal lumbar interbody fusion (TLIF) has been widely accepted to treat these diseases and is associated with less trauma and blood loss compared to posterior lumbar interbody fusion [4][5][6]. However, extensive paravertebral muscle stripping and retraction is still needed to obtain an adequate surgical field during TLIF [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Tranexamic Acid for Blood Loss after Transforaminal Posterior Lumbar Interbody Fusion Surgery: A Double-Blind, Placebo-Controlled, Randomized Study

et al. 2020

BioMed Research International

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Background. Transforaminal lumbar interbody fusion (TLIF) may result in significant blood loss and an increase in blood transfusion. Though tranexamic acid (TXA) is widely studied for the hemostasis of arthroplasty, there is little information on the use of TXA for TLIF surgery. Methods. This prospective randomized, double-blind, placebo-controlled trial was conducted to study the influence of TXA (intravenous bolus of 10 mg/kg 15 minutes before skin incision followed by intravenous infusion of 6-8 mg/kg/h up to a total dose of 15 mg/kg during the surgery) on the blood loss and Enhanced Recovery After Surgery (ERAS) after TLIF surgery. 40 patients were randomized into two groups: TXA group (tranexamic acid) and control group (placebo). Baseline characteristics were comparable between the TXA group and the control group before the surgery. Outcomes assessed included blood loss, total postoperative drainage, time for drainage removal, time to ambulation, hospital stay after surgery, postoperative hemoglobin (Hb) one day after surgery, and adverse events. Results. Compared to patients in the control group after TLIF surgery, patients in the TXA group have significantly reduced intraoperative hemorrhage and time to ambulation after surgery but show similar hospital stay, postoperative drainage, time for drainage removal, postoperative Hb one day after surgery, and adverse events. Conclusions. TXA shows important ability in controlling blood loss and promoting the ERAS after TLIF surgery.

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“…Successful surgery requires a motionless and clear surgical field, and even minimal bleeding interfering with the visualization of the operative area can lead to increased operative time and complications. [28–30] Previous study reports that magnesium sulfate is capable of reducing arterial pressure, heart rate, blood loss, and duration of sinus surgery. [15] Improved quality of the surgical field is observed after magnesium sulfate application during endoscopic sinus surgery.…”

Section: Discussionmentioning

confidence: 99%

The effect of magnesium sulfate on surgical field during endoscopic sinus surgery

Liu

Jiang²,

Pu³

et al. 2019

Medicine

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Introduction: The benefits of magnesium sulfate for surgical field during endoscopic sinus surgery remain controversial. We conduct a systematic review and meta-analysis to explore the influence of magnesium sulfate versus placebo on surgical field during endoscopic sinus surgery. Methods: We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through November 2018 for randomized controlled trials (RCTs) assessing the effect of magnesium sulfate versus placebo on surgical field during endoscopic sinus surgery. This meta-analysis is performed using the random-effect model. Results: Four RCTs and 404 patients are included in the meta-analysis. Overall, compared with control group endoscopic sinus surgery, magnesium sulfate has remarkably positive impact on surgical field scores (MD = −1.76; 95% CI = −2.33 to −1.18; P < .00001), and intraoperative blood loss (MD = −89.09; 95% CI = −163.20 to −14.97; P = .02), but shows no markedly effect on surgery duration (MD = −7.08; 95% CI = −21.38 to 7.22; P = .33), fentanyl (MD = −0.64; 95% CI = −1.97 to 0.70; P = .35), and vecuronium (MD = −3.64; 95% CI = −10.99 to 3.70; P = .33). Conclusions: Magnesium sulfate exerts positive impact on surgical field and blood loss reduction for endoscopic sinus surgery.

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Comparison of Minimally Invasive and Open Transforaminal Lumbar Interbody Fusion for Lumbar Disc Herniation: A Retrospective Cohort Study

Cited by 24 publications

References 40 publications

Robot-Guided Transforaminal Versus Robot-Guided Posterior Lumbar Interbody Fusion for Lumbar Degenerative Disease

Robot-Guided Transforaminal Versus Robot-Guided Posterior Lumbar Interbody Fusion for Lumbar Degenerative Disease

Tranexamic Acid for Blood Loss after Transforaminal Posterior Lumbar Interbody Fusion Surgery: A Double-Blind, Placebo-Controlled, Randomized Study

The effect of magnesium sulfate on surgical field during endoscopic sinus surgery

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