开放式与双ortal 内窥镜经椎间孔腰椎椎体融合术的全身炎症指标和临床疗效比较

IF 2.8 3区医学 Q1 Pharmacology, Toxicology and Pharmaceutics

Therapeutics and Clinical Risk Management Pub Date : 2024-05-07 DOI:10.2147/tcrm.s447394

Liwen Feng, Junbo Liang, Naiguo Wang, Qingyu Zhang

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引用次数: 0

摘要

目的：本研究旨在初步评估开放式TLIF和BE-TLIF手术围手术期全身炎症指标的变化和临床结果：回顾性分析了38例接受单水平腰椎融合手术（L4-5或L5-S1）的患者。19名患者接受了BE-TLIF技术治疗，其他患者则接受了开放式TLIF治疗。比较了两组患者围手术期血清 C 反应蛋白（CRP）、中性粒细胞/淋巴细胞比值（NLR）、淋巴细胞/单核细胞比值（LMR）和血小板/淋巴细胞比值（PLR），以确定是否存在统计学差异。同时，还进行了临床评估，以评估各种因素，包括手术时间、估计失血量（EBL）、引流导管留置时间、住院时间、视觉模拟量表（VAS）和 Oswestry 残疾指数（ODI）评分：围手术期分析显示，BE-TLIF 病例的手术时间长于开放式 TLIF 病例（开放式 TLIF：138.63±31.59 分钟，BE-TLIF：204.58±49.37 分钟，P < 0.001）。同时，与开放式 TLIF 组（200.9 ± 211.9 mL）相比，BE-TLIF 组的 EBL 呈上升趋势（260.7 ± 211.9 mL）（p =0.485）。在全身炎症指标方面，BE-TLIF 组的术后 CRP、NLR、LMR 和 PLR 平均值低于开放式 TLIF 组，但差异无统计学意义（p > 0.05）。两组的 VAS 和 ODI 评分在术后均有明显改善（p < 0.05）：结论：BE-TLIF 和开放式 TLIF 在全身炎症指标和临床疗效方面无明显差异。总之，BE-TLIF 是一种可行的腰椎管减压和椎间融合术，其创伤较小。值得注意的是，BE-TLIF 的手术时间较长，这表明该技术仍有进一步改进的潜力。

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Systemic Inflammatory Markers and Clinical Outcomes of Open versus Biportal Endoscopic Transforaminal Lumbar Interbody Fusion

Purpose: The purpose of this study is to preliminarily assess the change in perioperative systemic inflammatory markers and clinical outcomes between open TLIF and BE-TLIF procedures.
Patients and Methods: In total, 38 patients who underwent single-level lumbar fusion surgery (L4-5 or L5-S1) were retrospectively reviewed. 19 patients were treated by the BE-TLIF technique, while the other patients were managed using open TLIF. The perioperative serum C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR), and platelet/lymphocyte ratio (PLR) of the two groups were compared to determine if there was a statistical difference. Meanwhile, clinical evaluations were conducted to assess various factors including operative duration, estimated blood loss (EBL), drainage catheter stay, length of hospitalization, visual analogue scale (VAS), and Oswestry disability index (ODI) scores.
Results: The perioperative analysis revealed that BE-TLIF cases experienced a longer operative duration than open TLIF cases (open TLIF: 138.63 ± 31.59 min, BE-TLIF: 204.58 ± 49.37 min, p < 0.001). Meanwhile, the EBL showed an increased trend in the BE-TLIF group (260.7 ± 211.9 mL) in comparison with the open TLIF group (200.9 ± 211.9 mL) (p =0.485). In terms of systemic inflammatory markers, the mean postoperative CRP, NLR, LMR, and PLR were lower in the BE-TLIF group than in the open TLIF group, although these differences were not statistically significant (p > 0.05). The VAS and ODI scores in both groups were significantly improved after surgery (p < 0.05).
Conclusion: There was no significant difference found between BE-TLIF and open TLIF in terms of systemic inflammatory markers, and clinical outcomes. Overall, BE-TLIF can be considered a viable choice for lumbar canal decompression and interbody fusion for less invasion. It is worth noting that BE-TLIF does have a longer operation time, indicating that there is still potential for further improvement in this technique.

Keywords: transforaminal lumbar interbody fusion, unilateral biportal endoscope, systemic inflammatory markers

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来源期刊

Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-

CiteScore

5.30

自引率

3.60%

发文量

139

审稿时长

16 weeks

期刊介绍： Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.