Quantitative Study Of MIS-TLIF And TLIF On Degree Of Paravertebral Muscles Injury By MRI

Objective To quantitatively compare minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)and transforaminal lumbar interbody fusion(TLIF)on degree of paravertebral muscles injury in treatment of lumbar degenerative disease.Metheods The clinical data of 48 patients with lumbar degenerative disease who underwent single segment surgical treatment from October 2015 to November 2017 were retrospectively analyzed.22 patients were treated by MIS-TLIF.There were 10 males and 12 females.26 patients were treated by TLIF.There were 11 males and 15 females.The operation time,intraoperative blood loss,postoperative volume of drainage and bed time were compared among the 2 groups.The results were evaluated according preoperation and 1 week postoperation VAS and MRI examination.We also measured and calculated the lean muscles cross sectional area(LMCSA)by MRI image.Results Preoperation VAS:there were no significant differences between the MIS-TLIF group(7.45±1.18)scores and the TLIF group(7.42±1.14)scores(P>0.05).Preoperation LMCSA:MIS-TLIF group(651.80±58.86)mm2 and TLIF group(640.97±65.22)mm2.There were no statistically significant differences(P>0.05).Operation time:MIS-TLIF group(139.45±13.91)min and TLIF group(144.77±14.59)min.There were no statistically significant differences(P>0.05).Intraoperative blood loss:the MIS-TLIF group(119.32±8.22)ml,which was lower than that of the TLIF group(279.12±18.88)ml,with statisticall significance(P<0.05).Postoperative volume of drainage:MIS-TLIF group(62.27±6.07)ml and TLIF group(122.88±9.31)ml.The postoperative volume of drainage in MIS-TLIF group was lower than that in TLIF group(P<0.05).Bed time:MIS-TLIF group(7.14±0.83)d and TLIF group(10.42±0.90)d.The bed time in MIS-TLIF group was lower than that in TLIF group(P<0.05).1 week postoperation VAS:there were no significant differences between the MIS-TLIF group(1.77±0.69)scores and the TLIF group(2.08±0.56)scores(P>0.05).Surgical improvement rate:MIS-TLIF group(-75.95±8.94)%and TLIF group(-71.3 8±8.89)%.There were no statistically significant differences(P>0.05).1 week postoperation LMCSA:the MIS-TLIF group(591.70±52.81)mm2,which was higher than that of the TLIF group(528.17±60.41)mm2,with statisticall significance(P<0.05).The 1 week postoperation VAS and LMCSA in 2 groups were lower than preoperation VAS and LMCSA in 2 groups(P<0.05).Change rate of LMCSA:the MIS-TLIF group(-9.19±2.56)%,which was lower than that of the TLIF group(-17.68±2.07)%,with statisticall significance(P<0.05).Conclusions By comparing the MRI before and after operation,we found that the degree of injury of MIS-TLIF to paravertebral muscles was significantly less than TLIF.