Quadrant Assisted Minimally Invasive TLIF System And Lumbar Degenerative Disease Of Single Intervertebral Disc Space

Objective:To explore safety, clinical efficacy of Quadrant assisted minimally invasive system for transforaminal lumbar interbody fusion(TLIF) lumbar degenerative disease of single intervertebral disc space.Methods:1. Subjects and grouping:To select January 2012-2014 in January in our hospital 62 cases of lumbar degenerative disease patients as research subjects, using digital representation of the minimally invasive group were randomly divided into groups and open.2. Methods:31 patients underwent minimally invasive systems Quadrant TLIF treatment,31 patients underwent open TLIF open-assisted therapy. Two groups of patients were operative time, length of incision, blood loss, postoperative drainage and other surgical case record; at the same time, the detection Preoperative and postoperative day C-reactive protein (CRP) and creatine kinase (CK) levels, in order to determine the extent of tissue damage in patients; for all patients for a period of 1 year follow-up visits by visual analogue (VAS) score and the Oswestry Disability Index (ODI) for different periods of pain, the patient was evaluated and observe whether patients with adverse circumstances.Results:1. Comparison of surgery-related indicators:two groups were compared to relevant indicators, minimally invasive operative time (2.75 ± 0.36) h, incision length (3.64 ± 0.31) cm, blood loss (219.52 ± 105.17) ml, postoperative drainage Flow (73.82 ± 21.97) ml, after time in the hospital (5.21 ± 0.89) d, open operative time (2.89 ± 0.43) h, incision length (8.79 ± 1.24) cm, blood loss (642.82 ± 198.64) ml postoperative drainage (231.03 ± 73.64) ml, after time in the hospital (7.32 ± 2.01) d. Minimally invasive surgery group at the time, incision length, blood loss, postoperative drainage and postoperative hospital in time have to be significantly better than the dinner group (P<0.05), operative time compared with no statistical significance (P>0.05).2. Intraoperative X-ray exposure:the minimally invasive group when radiation length X-ray, DAP and SED were significantly higher than the open group (P<0.05), the differences were statistically significant, the minimally invasive group intraoperative X-ray exposure and more serious.3. The two VAS, ODI scores:open group before surgery VAS, ODI scores were (8.7 ± 1.0) points, (45.7 ± 1.8) points, minimally invasive group (8.8 ±1.1) points, respectively, ODI score (45.6 ± 1.7) points, postoperative VAS scores, ODI scores were significantly decreased appeared (P<0.05). Follow-up results also show that the minimally invasive group ye after two weeks, three months, six months when the VAS score and ODI scores were significantly lower than the open group (P<0.05), but after a year when two sets of scores were no significant differences (P> 0.05) compared to.4. The two CRP, CK level comparison:Preoperative CRP, CK levels and there is not much difference (P> 0.05). After the first day, the minimally invasive group compared with the open group was significantly lower (P<0.05), a statistically significant difference.5. Complications and recovery groups:All 62 patients were treated successfully and discharged. Group 1 patients minimally invasive open surgery group 3 patients had wound infection after using antibiotics were recovered in two weeks, all patients patient positioning error does not occur, cerebrospinal fluid leakage, nerve damage and other complications. Follow-up results showed that both groups of patients showed better graft bone fusion.Conclusions:1. Quadrant assisted minimally invasive TLIF system compared with open TLIF, intraoperative patient harm caused smaller, with shorter operative time, less blood loss and other advantages, but intraoperative X-ray exposure time is longer.2. Quadrant assisted minimally invasive TLIF system less impact associated with tissue damage in patients with biochemical indicators of stress response occurs lighter, with minimally invasive characteristics.3. Quadrant system assisted minimally invasive TLIF long-term efficacy and open TLIF are very significant, but Quadrant assisted minimally invasive TLIF system after a short time can quickly improve the quality of life in patients, the short-term effect is better.4. Quadrant system assisted minimally invasive treatment of lumbar degenerative disease TLIF is a safe and effective surgical method, it makes up for some of the drawbacks of open TLIF, embodies the modern concept of minimally invasive surgery and should be introduced in clinical practice.