Comparison Of Hidden Blood Loss And Clinical Efficacy Of PE-TLIF And MIS-TLIF Through The Channel

Purpose Hidden blood loss(HBL)is a growing area of interest for spinal surgeons.Simultaneously,spine surgeons’ pursuit of minimally invasive spine surgery has never ceased,as evidenced by the increasing number of articles comparing percutaneous endoscopic transforaminal lumbar interbody fusion(PE-TLIF)and minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF).However,there has been no comparison of HBL between PE-TLIF and MIS-TLIF.This study aimed to compare HBL,visible blood loss(VBL),and total blood loss(TBL)following PE-TLIF and MIS-TLIF and evaluate the clinical signifcance of these procedures.Methods Between May 2018-January 2020,105 patients underwent lumbar interbody fusion at our institution and were followed up for at least 2 years.Our study included 56 PE-TLIF and 49 MIS-TLIF cases.We recorded each patient’s age,height,weight,and haematocrit and calculated the TBL,which was used to indirectly obtain the HBL.Additionally,we compared the clinical outcomes of these two groups,including visual analogue scores for the lumbar spine and leg(VAS-Back;VAS-Leg),Oswestry Disability Index(ODI),Japanese Orthopaedic Association(JOA)scores,disease type,operative segment,and intervertebral fusion and complication rates.Results PE-TLIF had signifcantly lower HBL,VBL,and TBL values than MIS-TLIF(P<0.05 for all).Although PE-TLIF contained signifcantly less HBL than MIS-TLIF,the HBL to TBL ratio was statistically greater in PE-TLIF than in MIS-TLIF.Concerning clinical outcomes,VAS-Back,VAS-Leg,ODI,JOA,and PE-TLIF demonstrated greater improvement rates than MIS-TLIF one week post-operatively.However,at the fnal follow-up,VAS-Back,VAS-Leg,ODI,and JOA scores all demonstrated a trend toward sustained improvement,with no statistically signifcant betweenprocedure diference.There were no statistically signifcant between-procedure diferences in disease type,surgical segment,and complication or fusion rates.Conclusion The HBL,VBL,and TBL were significantly lower in the PE-TLIF group than in the MIS-TLIF group.At the short-term follow-up,the clinical outcome of the PE-TLIF group was also better than that of the MIS-TLIF group.At the final follow-up,no significant difference in clinical outcome between the groups.