Clinical Study On Treatment Of The Moderate Or Severe Lumbar Spondylolisthesis Assisted By Quadrant Minimally Invasive System

Objective: To prospectively study the clinical efficacy and safety of minimally invasive low lumbar spinal decompression and intervertebral fusion or internal fixation in the treatment of moderate and severe lumbar spondylolysis.Methods: From July,2017 to March,2019,40 patients with single stage moderate to severe lumbar spondylolisthesis were admitted and treated by concurrent surgery in our hospital.They were randomly divided into two groups,among them,20 patients were treated with minimally transforaminal lumbar interbody fusion(MIS-TLIF),which was called the minimally invasive group,and 20 patients were treated with traditional posterior open lumbar decompression intervertebral fusion(PLIF),which was called the open group.The indexes of operation time,intraoperative blood loss,postoperative drainage volume and postoperative bed rest time were recorded and compared between the two groups.Postoperative vertebral slippage rate and intervertebral space height were compared between the two groups before surgery,1 week after surgery,6 months after surgery and the last follow-up.VAS score and ODI score were compared between the minimally invasive group and the open group before surgery,1 week after surgery,6 months after surgery,and at the last follow-up.All data were analyzed by statistical software SPSS19.0.Results: All cases were followed up for 12 to 24 months.All patients had no intraoperative nerve or dural sac injury,no postoperative cerebrospinal fluid leakage and wound infection,no screw loosening or fracture complications.There was no significant difference in general data between the minimally invasive group and the open group(P>,0.05),suggesting comparability.The amount of intraoperative blood loss,postoperative drainage volume and postoperative bed rest time in the minimally invasive group were better than those in the open group,with statistically significant differences(P<0.05).The operation time of the minimally invasive group was longer than that of the open group,and the difference was statistically significant(P<0.05).VAS scores and ODI scores were compared between the micro wound group and the open group one week after surgery,and the differences were statistically significant(P<0.05).VAS scores and ODI scores were not statistically significant between the two groups six months after surgery or above(P>0.05).VAS score and ODI score before and after operation were compared between the two groups,and the differences were statistically significant(P<0.05).The difference in intervertebral space height and slippage rate between the minimally invasive group and the open group was not statistically significant(P>,0.05).The difference of intervertebral space height and slippage rate between the two groups before and after operation was statistically significant(P<0.05).Conclusions: Quadrant minimally invasive system low spinal decompression and intervertebral fusion and internal fixation in the treatment of moderate and severe lumbar spondylitis has the advantages of less surgical trauma,less intraoperative blood loss,less postoperative drainage,shorter postoperative bed time and faster postoperative recovery,etc.It is a minimally invasive surgical method with good safety and good early clinical efficacy.