Comparative Study Of The Short-term Results Of MIS-TLIF And ZELF In The Treatment Of Degenerative Lumbar Diseases

Objective:This paper aims to make a comparison of short-term results of MIS-TLIF(minimally invasive transforaminal lumbar interbody fusion)and ZELIF(zessys endoscope lumbar interbody fusion)in the treatment of lumbar degenerative diseases.Methods:From March 2019 to March 2020,a retrospective study was conducted on 25 patients with unilateralsymptomatic lumbar degenerative diseases in our hospital,including lumbar spinal stenosis and lumbar instability,lumbar spondylolisthesis(Meyerding grade I),lumbar disc herniation,discogenic low back pain.And the patients underwent single-segment lumbar intervertebral fusion and internal fixation in the same medical group of the department of spinal surgery.According to the operative procedures,they were divided into MIS-TLIF group and ZELIF group.in MIS-TLIF group,13 patients were randomly selected,including 5 males and 8 females,with an average age of 67.84±5.32 years,12 patients in ZELIF group,7 males and 5 females,with an average age of 65.24±8.16 years.There was no statistical difference(P<0.05)in age,gender,BMI,course of disease,surgical segment distribution.Clinical efficacy:VAS(Visual Analogue Score)and JOA(Japanese Orthopaedic Associaation)score of lumbar and leg pain during preoperative,at 3 days,1month after surgery and last follow-up.Perioperative related indexes: operation time,intraoperative bleeding,postoperative drainage,postoperative hospital stay,complications.Imaging indexes:intervertebral space height,intervertebral foramen height,axial vertebral canal sagittal diameter of surgical segment,intervertebral fusion cage.Results:There were significant differences in VAS score and JOA score between preoperative and last follow-up groups(P< 0.05).The VAS score in ZELIF group was significantly lower than those in MIS-TLIF group at 3 days and 1 month.There was no significant difference in VAS score of leg pain at each time point.The amount of bleeding,postoperative drainage and postoperative hospital stay in ZELIF were lower than those in MIS-TLIF(P < 0.05),but the operation time was longer(279.83± 77.39 min vs 204.07±31.66 min,P < 0.05).There was no significant difference in intervertebral space,intervertebral foramen height and sagittal diameter between the two groups.No Cage subsidence were found in the last follow-up.Conclusion:Both ZELIF and MIS-TLIF can obtain satisfactory short-term clinical effect in the treatment of lumbar degenerative diseases with unilateral neurological symptoms.ZELIF is a new technical field,which has the advantages of small injury,less bleeding and fast recovery.It is worth popularizing in clinic.