| Objective: To explore the variation of minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)with real-time 3D navigation techniques with traditional open transforaminal lumbar interbody fusion on lumbosacral sagittal parameters in the treatment of lumbar degenerative disease.Methods: The retrospective study was conducted on 61 patients with degenerative lumbar disease after undergoing single level fusion from September 2012 to December2019.The 31 cases underwent MIS-TLIF with 3D navigation techniques and another30 cases underwent conventional open TLIF.In two groups,the clinical information,operation time,intraoperative blood loss and postoperative hospitalization time were all recorded.The sagittal radiologic parameters in patients were measured before surgery and at the final follow-up after surgery,including lumbar lordosis(LL),segmental lordosis(SL),pelvic incidence(PI),pelvic tilt(PT),sacral slope(SS),fusion level anterior disc height(ADH),middle disc height(MDH),posterior disc height(PDH),and the average disc height(DH)and pelvic incidence to lumbar lordosis mismatch(PI-LL)were calculated.Results: There was no statistical difference between two groups in age,gender,preoperative diagnosis,operative levels and preoperative sagittal radiologic parameters.The operative time,intraoperative blood loss and postoperative hospitalization time in the navigation assisted MIS-TLIF group were significantly less than those in the traditional open TLIF group,and the differences were statistically significant(P<0.05).At final follow-up,the patients in the navigation assisted MIS-TLIF group showed significant increase in lumbar lordosis from(39.4±12.3)° to(43.9±11.1)° for a change of(4.5±9.6)°,segmental lordosis increased from(7.2±5.3)°to(9.5±4.2)°for a change of(2.3±4.4)°,average disc height increased from(12.1±1.9)mm to(13.2±2.1)mm for a change of(1.1±1.6)mm,pelvic incidence to lumbar lordosis mismatch decreased from(8.0±13.7)° to(3.5±11.9)° for a change of(-4.5±9.8)°,and the patients in the traditional open TLIF group showed significant increase in lumbar lordosis from(38.1±12.9)° to(44.1±10.0)° for a change of(6.0±9.4)°,average disc height increased from(11.4±1.8)mm to(12.8±1.5)mm for a change of(1.4±1.8)mm,pelvic incidence to lumbar lordosis mismatch decreased from(10.7±8.9)° to(4.7±8.5)° for a change of(-6.0±7.7)°,and the differences were statistically significant(P<0.05).There was no statistically significant difference in lumbar lordosis,pelvic incidence,pelvic tilt,sacral slope,pelvic incidence to lumbar lordosis mismatch,segmental lordosis,disc height between the two groups(P>0.05).Conclusions: 1.Compared with open TLIF,real-time navigation assisted MIS-TLIF in the treatment of patients with degenerative lumbar diseases has the advantages of short operation time,less intraoperative bleeding and short postoperative hospitalization time.2.Real-time navigation assisted MIS-TLIF and the traditional open TLIF in the treatment of degenerative lumbar diseases can both restore disc height in a short term and improve lumbar lordosis and pelvic incidence to lumbar lordosis mismatch,and then the sequence of sagittal plane in lumbosacral region was more harmonious. |
