The article discusses the clinical efficacy of percutaneous endoscopic large-channel fusion and transforaminal lumbar interbody fusion (TLIF) in the treatment of degenerative lumbar spinal stenosis. The study, which was a retrospective study conducted at Nanjing Lishui People’s Hospital in China, included 100 patients with degenerative lumbar spinal stenosis. The participants were randomly divided into an intervention group and a control group, with the intervention group receiving percutaneous endoscopic large-channel fusion and internal fixation, and the control group receiving TLIF. The study measured various outcomes such as perioperative indexes, clinical efficacy, inflammatory responses, postoperative pain, lumbar function, and complications. The results showed that the intervention group had better perioperative and inflammatory response indexes, a higher total effective rate, lower incidence of postoperative complications, and better pain relief and functional outcomes compared to the control group. The study concludes that both methods had good therapeutic effects, but percutaneous endoscopic large-channel fusion was more effective and beneficial for patients
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best rated spine clinic in London
Published article
CONCLUSIONS: Both percutaneous, endoscopic, large-channel fusion and TLIF had good therapeutic effects in the treatment of degenerative lumbar spinal stenosis. However, compared with the latter, the former was more effective, with better comprehensive efficacy and more obvious benefits for patients, so it’s worthy of clinical promotion and use.
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Altern Ther Health Med. 2023 Sep 8:AT8546. Online ahead of print.ABSTRACTCONTEXT: Degenerative changes in the lumbar spine more commonly cause spinal stenosis and with the aging of society, its incidence is on the rise. Endoscopic spinal surgery is a minimally invasive technique for decompression. The efficacy of percutaneous, endoscopic, large-channel fusion and transforaminal lumbar interbody,
Altern Ther Health Med. 2023 Sep 8:AT8546. Online ahead of print.
ABSTRACT
CONTEXT: Degenerative changes in the lumbar spine more commonly cause spinal stenosis and with the aging of society, its incidence is on the rise. Endoscopic spinal surgery is a minimally invasive technique for decompression. The efficacy of percutaneous, endoscopic, large-channel fusion and transforaminal lumbar interbody fusion (TLIF) need confirmation by more studies.
OBJECTIVE: The study intended to investigate the clinical efficacy of percutaneous endoscopic large-channel fusion and TLIF in the treatment of degenerative lumbar spinal stenosis, to find the best treatment plan.
DESIGN: The research team performed a retrospective study.
SETTING: The study took place at Nanjing Lishui People’s Hospital in Nanjing, Jiangsu Province, PR China.
PARTICIPANTS: Participants were 100 patients with degenerative, lumbar, spinal stenosis who had been admitted to the hospital between October 2018 and October 2022.
INTERVENTION: The research team randomly divided participants into an intervention group and a control group, with 50 participants in each group. The intervention group received percutaneous, endoscopic, large-channel fusion and internal fixation, and the control group received foraminal, lumbar, interbody fusion.
OUTCOME MEASURES: The research team measured: (1) perioperative indexes, (2) clinical efficacy at a postoperative follow-up at 6 months postintervention, (3) indexes for inflammatory responses at baseline and postintervention, (4) postoperative pain at baseline and at months 3 and 6 postintervention using a visual analog scale (VAS), (6) lumbar function at baseline and months 3 and 6 postintervention using the Oswestry Disability Index (ODI) and the Japanese Orthopedic Association (JOA) scale, and (7) complications.
RESULTS: Compared with the control group, the intervention group’s perioperatively related and inflammatory-response indexes were significantly better: (1) amount of bleeding- 112.67 ± 17.38 for the control group and 78.62 ± 10.52 for the intervention group (P = .002); (2) volume of drainage-79.63 ± 14.21 for the control group and 52.18 ± 8.21 for the intervention group (P = .001); (3) ESR at baseline and postintervention-22.41 ± 5.62 and 15.18 ± 5.26, respectively, for the control group and 22.58 ± 5.82 and 10.54 ± 3.18, respectively, for the intervention group, with P = .013 postintervention; and (4) CRP at baseline and postintervention-17.42 ± 3.52 and 13.98 ± 3.65 for the control group, respectively, and 18.65 ± 3.78 and 10.14 ± 2.78 for the intervention group, with P = .008 postintervention; Also, compared to the control group, the intervention group’s: (1) total effective rate was significantly higher (P = .018); (2) incidence of postoperative complications was significantly lower (P = .006); (3) VAS pain score was significantly lower at months 3 and 6, with P = .028 and P = .021, respectively; (4) Oswestry Disability Index (ODI) function score was significantly lower at months 3 and 6, with P = .016 and P = .014, respectively; and (5) postoperative JOA function score was significantly higher at months 3 and 6, with P = .011 and P = .007, respectively.
CONCLUSIONS: Both percutaneous, endoscopic, large-channel fusion and TLIF had good therapeutic effects in the treatment of degenerative lumbar spinal stenosis. However, compared with the latter, the former was more effective, with better comprehensive efficacy and more obvious benefits for patients, so it’s worthy of clinical promotion and use.
PMID:37678853
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Clinical Study of Percutaneous Endoscopic Large-channel Fusion and Transforaminal Lumbar Interbody Fusion in the Treatment of Degenerative Lumbar Spinal Stenosis
